Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre

被引:2
|
作者
Sartini, Stefano [1 ]
Spadaro, Marzia [1 ]
Cutuli, Ombretta [1 ]
Castellani, Luca [1 ]
Sartini, Marina [2 ,3 ]
Cristina, Maria Luisa [2 ,3 ]
Canepa, Paolo [4 ]
Tognoni, Chiara [4 ]
Lo, Agnese [4 ]
Canata, Lorenzo [4 ]
Rosso, Martina [5 ]
Arboscello, Eleonora [1 ]
机构
[1] San Martino Policlin Univ Hosp, UOC MECAU, Emergency Med Dept, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
[2] Univ Genoa, Dept Hlth Sci, I-16128 Genoa, Italy
[3] Galliera Hosp, Hosp Hyg Unit, Via Alessandro Volta 8, I-16128 Genoa, Italy
[4] Univ Genoa, Emergency Med Postgrad Sch, Via Balbi 5, I-16126 Genoa, Italy
[5] Univ Genoa, Sch Med, Via Balbi 5, I-16126 Genoa, Italy
关键词
trauma; coagulopathy; anticoagulants; antiplatelets; antithrombotic agents; bleeding; hemorrhage; BRAIN-INJURY; FIBRINOGEN LEVELS; COAGULOPATHY; IMPACT; EPIDEMIOLOGY; PREDICTORS; HEMORRHAGE; MORTALITY; AGE;
D O I
10.3390/jcm11195764
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Antithrombotic therapy may affect outcomes in major trauma but its role is not fully understood. We aimed to investigate adverse outcomes among those with and without antithrombotic treatment in major trauma. Material and methods: This is a retrospective study conducted at the Emergency Department (ED) of the University Hospital of Genoa, a tertiary trauma center, including all major trauma between January 2019 and December 2020. Adverse outcomes were reviewed among those without antithrombotic treatment (Group 0), on antiplatelet treatment (Group 1), and on anticoagulant treatment (Group 2). Results: We reviewed 349 electronic charts for full analysis. Group 0 were n = 310 (88.8%), Group 1 were n = 26 (7.4%), and Group 2 were n = 13 (3.7%). In-hospital death and ICU admission, respectively, were: n = 16 (5.6%) and n = 81 (26%) in Group 0, none and n = 6 (25%) in Group 1, and n = 2 (15.8%) and n = 4 (30.8%) in Group 2 (p = 0.123-p = 0.874). Altered INR (OR 5.2) and increasing D-dimer levels (AUC: 0.81) correlated to increased mortality. Discussion: Group 2 showed higher mortality than Group 0 and Group 1, however Group 2 had fewer active treatments. Of clotting factors, only altered INR and elevated D-dimer levels were significantly correlated to adverse outcomes. Conclusions: Anticoagulant but not antiplatelet treatment seems to produce the worst outcomes in major trauma.
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页数:9
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