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Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients
Preinjury anticoagulation therapy (AT) is associated with a higher risk for major bleeding. We aimed to evaluated the influence of preinjury anticoagulant medication on the clinical course after moderate and severe trauma. Patients in the TraumaRegister DGU ≥ 55 years who received AT were matched wi...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313576/ https://www.ncbi.nlm.nih.gov/pubmed/34312424 http://dx.doi.org/10.1038/s41598-021-94675-7 |
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author | Bläsius, Felix M. Laubach, Markus Andruszkow, Hagen Lübke, Cavan Lichte, Philipp Lefering, Rolf Hildebrand, Frank Horst, Klemens |
author_facet | Bläsius, Felix M. Laubach, Markus Andruszkow, Hagen Lübke, Cavan Lichte, Philipp Lefering, Rolf Hildebrand, Frank Horst, Klemens |
author_sort | Bläsius, Felix M. |
collection | PubMed |
description | Preinjury anticoagulation therapy (AT) is associated with a higher risk for major bleeding. We aimed to evaluated the influence of preinjury anticoagulant medication on the clinical course after moderate and severe trauma. Patients in the TraumaRegister DGU ≥ 55 years who received AT were matched with patients not receiving AT. Pairs were grouped according to the drug used: Antiplatelet drugs (APD), vitamin K antagonists (VKA) and direct oral anticoagulants (DOAC). The primary end points were early (< 24 h) and total in-hospital mortality. Secondary endpoints included emergency surgical procedure rates and surgery rates. The APD group matched 1759 pairs, the VKA group 677 pairs, and the DOAC group 437 pairs. Surgery rates were statistically significant higher in the AT groups compared to controls (APD group: 51.8% vs. 47.8%, p = 0.015; VKA group: 52.4% vs. 44.8%, p = 0.005; DOAC group: 52.6% vs. 41.0%, p = 0.001). Patients on VKA had higher total in-hospital mortality (23.9% vs. 19.5%, p = 0.026), whereas APD patients showed a significantly higher early mortality compared to controls (5.3% vs. 3.5%, p = 0.011). Standard operating procedures should be developed to avoid lethal under-triage. Further studies should focus on detailed information about complications, secondary surgical procedures and preventable risk factors in relation to mortality. |
format | Online Article Text |
id | pubmed-8313576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-83135762021-07-28 Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients Bläsius, Felix M. Laubach, Markus Andruszkow, Hagen Lübke, Cavan Lichte, Philipp Lefering, Rolf Hildebrand, Frank Horst, Klemens Sci Rep Article Preinjury anticoagulation therapy (AT) is associated with a higher risk for major bleeding. We aimed to evaluated the influence of preinjury anticoagulant medication on the clinical course after moderate and severe trauma. Patients in the TraumaRegister DGU ≥ 55 years who received AT were matched with patients not receiving AT. Pairs were grouped according to the drug used: Antiplatelet drugs (APD), vitamin K antagonists (VKA) and direct oral anticoagulants (DOAC). The primary end points were early (< 24 h) and total in-hospital mortality. Secondary endpoints included emergency surgical procedure rates and surgery rates. The APD group matched 1759 pairs, the VKA group 677 pairs, and the DOAC group 437 pairs. Surgery rates were statistically significant higher in the AT groups compared to controls (APD group: 51.8% vs. 47.8%, p = 0.015; VKA group: 52.4% vs. 44.8%, p = 0.005; DOAC group: 52.6% vs. 41.0%, p = 0.001). Patients on VKA had higher total in-hospital mortality (23.9% vs. 19.5%, p = 0.026), whereas APD patients showed a significantly higher early mortality compared to controls (5.3% vs. 3.5%, p = 0.011). Standard operating procedures should be developed to avoid lethal under-triage. Further studies should focus on detailed information about complications, secondary surgical procedures and preventable risk factors in relation to mortality. Nature Publishing Group UK 2021-07-26 /pmc/articles/PMC8313576/ /pubmed/34312424 http://dx.doi.org/10.1038/s41598-021-94675-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Bläsius, Felix M. Laubach, Markus Andruszkow, Hagen Lübke, Cavan Lichte, Philipp Lefering, Rolf Hildebrand, Frank Horst, Klemens Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients |
title | Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients |
title_full | Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients |
title_fullStr | Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients |
title_full_unstemmed | Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients |
title_short | Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients |
title_sort | impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313576/ https://www.ncbi.nlm.nih.gov/pubmed/34312424 http://dx.doi.org/10.1038/s41598-021-94675-7 |
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