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

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 (...

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Autores principales: Sartini, Stefano, Spadaro, Marzia, Cutuli, Ombretta, Castellani, Luca, Sartini, Marina, Cristina, Maria Luisa, Canepa, Paolo, Tognoni, Chiara, Lo, Agnese, Canata, Lorenzo, Rosso, Martina, Arboscello, Eleonora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573302/
https://www.ncbi.nlm.nih.gov/pubmed/36233632
http://dx.doi.org/10.3390/jcm11195764
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author Sartini, Stefano
Spadaro, Marzia
Cutuli, Ombretta
Castellani, Luca
Sartini, Marina
Cristina, Maria Luisa
Canepa, Paolo
Tognoni, Chiara
Lo, Agnese
Canata, Lorenzo
Rosso, Martina
Arboscello, Eleonora
author_facet Sartini, Stefano
Spadaro, Marzia
Cutuli, Ombretta
Castellani, Luca
Sartini, Marina
Cristina, Maria Luisa
Canepa, Paolo
Tognoni, Chiara
Lo, Agnese
Canata, Lorenzo
Rosso, Martina
Arboscello, Eleonora
author_sort Sartini, Stefano
collection PubMed
description 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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spelling pubmed-95733022022-10-17 Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre Sartini, Stefano Spadaro, Marzia Cutuli, Ombretta Castellani, Luca Sartini, Marina Cristina, Maria Luisa Canepa, Paolo Tognoni, Chiara Lo, Agnese Canata, Lorenzo Rosso, Martina Arboscello, Eleonora J Clin Med Article 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. MDPI 2022-09-29 /pmc/articles/PMC9573302/ /pubmed/36233632 http://dx.doi.org/10.3390/jcm11195764 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sartini, Stefano
Spadaro, Marzia
Cutuli, Ombretta
Castellani, Luca
Sartini, Marina
Cristina, Maria Luisa
Canepa, Paolo
Tognoni, Chiara
Lo, Agnese
Canata, Lorenzo
Rosso, Martina
Arboscello, Eleonora
Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre
title Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre
title_full Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre
title_fullStr Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre
title_full_unstemmed Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre
title_short Does Antithrombotic Therapy Affect Outcomes in Major Trauma Patients? A Retrospective Cohort Study from a Tertiary Trauma Centre
title_sort does antithrombotic therapy affect outcomes in major trauma patients? a retrospective cohort study from a tertiary trauma centre
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573302/
https://www.ncbi.nlm.nih.gov/pubmed/36233632
http://dx.doi.org/10.3390/jcm11195764
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