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Association of antiplatelet or anticoagulant agents with in-hospital mortality among blunt torso trauma patients without severe traumatic brain injury: A retrospective analysis of the Japanese nationwide trauma registry

      Highlights

      • The association of antithrombic agents with mortality among blunt torso trauma patients without severe traumatic brain injury remains unclear.
      • The use of pre-injury antithrombotic agents was not associated with higher mortality among patients without severe head trauma.
      • The use of pre-injury antithrombotic agents was not associated with higher rate of transfusion, surgery or increased complications.
      • Prompt intervention to prevent progressive coagulopathy and careful management are needed for patients taking antithrombotic agents.

      Abstract

      Aim

      Patients with head trauma who take antiplatelet or anticoagulant (APAC) agents have a higher rate of mortality. However, the association between these agents and mortality among blunt torso trauma patients without severe traumatic brain injury remains unclear.

      Methods

      Using the Japanese nationwide trauma registry, we conducted a retrospective cohort study including adult patients with blunt torso trauma without severe head trauma between January 2019 and December 2020. Eligible patients were divided into two groups based on whether or not they took any APAC agents. The primary outcome was in-hospital mortality. To adjust for potential confounding factors, we conducted random effects logistic regression to account for patients clustering within the hospitals. The model was adjusted for potential confounders, including age, mechanism of injury, Charlson comorbidity index, systolic blood pressure, and injury severity scale on arrival as potentially confounding factors.

      Results

      During the study period, 16,201 patients were eligible for the analysis. A total of 832 patients (5.1%) were taking antiplatelet or anticoagulant agents. Overall in-hospital mortality was 774 patients (4.8%). APAC group had a higher risk of in-hospital mortality compared with the non-APAC group (6.9% vs. 4.7%; unadjusted OR, 1.51; 95% CI, 1.12–2.00; P < 0.01). After adjusting for potential confounder, there were no significant intergroup difference in a higher in-hospital mortality compared to with the non-APAC group (OR, 1.07; 95%CI, 0.65–1.77; P = 0.79).

      Conclusion

      The use of APAC agents before the injury was not associated with higher in-hospital mortality among blunt torso trauma patients without severe traumatic brain injury.

      Key words

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