ANTICOAGULATION IS ASSOCIATED WITH INCREASED MORBIDITY AND MORTALITY IN CONCUSSIVE INJURY AMONG ELDERLY TRAUMA PATIENTS
Journal Title: IJSR-International Journal Of Scientific Research - Year 2019, Vol 8, Issue 5
Abstract
To study the association between concussive injury in elderly patients on anticoagulation and development of non-bleeding complication. A retrospective data analysis was performed comparing elderly trauma patients with concussion on antiplatelet therapy, anticoagulation or both. Data obtained included age, ISS, likelihood of development mental status alteration, change in CT scan, hospital length of stay, and survival. 1000 patients patients age > 65 years [elderly] with concussion were enrolled, 622 women and 378 men, all on either antiplatelet therapy, anticoagulation or dual therapy. Patients had an average age of 80 years with average ISS of 1.4. Between the 3 groups (antiplatelet, anticoagulation and dual therapy), notable differences were found in alteration of mental status requiring the obtaining of a repeat CT scan (44% vs. 63% vs. 85%, p < .0001), changes noted in CT scan at 24 hours (8% vs. 19% vs. 56%, p< .0001), hospital length of stay (days) (4.5 vs. 5.1 vs. 6.0, p < .0001), and survival (100% vs. 94% vs. 85%, p < .0001). We also noted a signicant difference between patients on aspirin or clopidogrel with regard to hospital length of stay (days) (4.2 vs. 5.4, p < .0001). Elderly patients on antiplatelet therapy with concussive injury were less prone to develop morbidity such mental status changes, changes in CT at 24 hours and prolonged hospital length of stay when compared to patients on anticoagulation or dual therapy. With 100% survival and hospital length of stay ranging between 4.2 to 5.4 days, raises questions with regard to resource allocation in concussed patients on only antiplatelet therapy. In patients on anticoagulation with or without antiplatelet therapy, changes in CT scan were unrelated to bleeding but more commonly found to be due to worsening of chronic conditions -- edema and prior infarction - possibly related to withholding of anticoagulation or antiplatelet therapy. Concussive injury in patients on anticoagulation is associated with a higher morbidity and mortality than patients with similar injury only on antiplatelet therapy. The change in mental status even with antiplatelet therapy would suggest observing these patients for at least 24 hours.
Authors and Affiliations
Krishna Akella, Samer Ibrahim*, Brian Boden, Akella Chendrasekhar
Keywords
Related Articles
- EP ID EP580984
- DOI -
- Views 32
- Downloads 0
PROBLEMS FACED BY GERIATRIC PEOPLE
The geriatric population has increased dramatically during the past 100 years. If the current trend continues, the number of persons aged 65 or older will more than double during the next 30 years. As a result, we need t...
A Study to Assess Awareness and Utilization of Reproductive and Child Health Services (RCH) Among Mothers in Urban Slum Population of Mumbai
Objective: 1) To study the level of awareness and utilization of RCH services among mothers in urban slums. 2) Socio demographic factors affecting it. Material and Methodology: A community based cross sectional, observat...
OBJECTIVE CLINICAL PAIN ASSESSMENT BY INDEPENDENT SERVICE IDENTIFIES SIGNIFICANT GAPS IN PAIN ASSESSMENT AND CONTROL.
Pain is highly subjective. Standardized measurements are necessary to ensure adequate analgesia. Our objective was to examine whether an independent objective clinical assessment differs from existing provider documented...
UNDERGRADUATE MEDICAL STUDENTS' AWARENESS AND PERCEPTION OF BARRIERS TOWARD EVIDENCE-BASED MEDICINE, EASTERN PROVINCE, SAUDI ARABIA; 2015 – 2016
Introduction Teaching Evidence-Based Medicine (EBM) is an essential part of developing competent future physicians. This study was designed to assess the level of knowledge, attitude, and perception of barriers to EBM am...
ABNORMAL UTERINE BLEEDING: CLINICOHISTOPATHOLOGICAL SPECTRUM AND CORRELATION
Background: Abnormal Uterine Bleeding (AUB) is considered one of the most common and challenging problems presenting to the gynecologists and accounts for as many as one third of all outpatients. Material and Methods: A...