Age is not associated with intracranial haemorrhage in patients with mild traumatic brain injury and oral anticoagulation.

Sauter, Thomas; Ziegenhorn, Stephan; Ahmad, Sufian; Hautz, Wolf; Ricklin, Meret; Leichtle, Alexander Benedikt; Fiedler, Martin; Haider, Dominik; Exadaktylos, Aristomenis (2016). Age is not associated with intracranial haemorrhage in patients with mild traumatic brain injury and oral anticoagulation. Journal of negative results in biomedicine, 15(1), p. 12. BioMed Central 10.1186/s12952-016-0055-y

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BACKGROUND Patients admitted to emergency departments with traumatic brain injury (TBI) are commonly being treated with oral anticoagulants. In contrast to patients without anticoagulant medication, no guidelines, scores or recommendations exist for the management of mild traumatic brain injury in these patients. We therefore tested whether age as one of the high risk factors of the Canadian head CT rule is applicable to a patient population on oral anticoagulants. METHODS This cross-sectional analysis included all patients with mild TBI and concomitant oral anticoagulant therapy admitted to the Emergency Department, Inselspital Bern, Switzerland, from November 2009 to October 2014 (n = 200). Using a logistic regression model, two groups of patients with mild TBI on oral anticoagulant therapy were compared - those with and those without intracranial haemorrhage. RESULTS There was no significant difference in age between the patient groups with (n = 86) and without (n = 114) intracranial haemorrhage (p = 0.078). In univariate logistic regression, GCS (OR = 0.419 (0.258; 0.680)) and thromboembolic event as reason for anticoagulant therapy (OR = 0.486 (0.257; 0.918)) were significantly associated with intracranial haemorrhage in patients with mild TBI and anticoagulation (all p < 0.05). However, there was no association with age (p = 0.078, OR = 1.024 (0.997; 1.051)), the type of accident or additional medication with acetylsalicylic acid or clopidogrel ((both p > 0.05; 0.552 (0.139; 2.202) and 0.256 (0.029; 2.237), respectively). CONCLUSION Our study found no association between age and intracranial bleeding. Therefore, until further risk factors are identified, diagnostic imaging with CCT remains necessary for mild TBI patients on oral anticoagulation of all ages, especially those with therapeutic anticoagulation because of thromboembolic events.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry

UniBE Contributor:

Sauter, Thomas; Ziegenhorn, Stephan; Ahmad, Sufian; Hautz, Wolf; Ricklin, Meret; Leichtle, Alexander Benedikt; Fiedler, Martin; Haider, Dominik and Exadaktylos, Aristomenis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1477-5751

Publisher:

BioMed Central

Language:

English

Submitter:

Romana Saredi

Date Deposited:

10 Feb 2017 07:43

Last Modified:

12 Feb 2017 02:14

Publisher DOI:

10.1186/s12952-016-0055-y

PubMed ID:

27401915

Uncontrolled Keywords:

Age; Anticoagulation; Mild traumatic brain injury; Risk factor

BORIS DOI:

10.7892/boris.94947

URI:

https://boris.unibe.ch/id/eprint/94947

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