@article{ref1,
title="Risk of unfavorable long-term outcome in older adults with traumatic intracranial hemorrhage and anticoagulant or antiplatelet use",
journal="American journal of emergency medicine",
year="2013",
author="Nishijima, Daniel K. and Shahlaie, Kiarash and Sarkar, Korak and Rudisill, Nancy and Holmes, James F.",
volume="31",
number="8",
pages="1244-1247",
abstract="STUDY OBJECTIVE: The objective was to compare neurological outcomes at 6 months in older patients with preinjury warfarin or clopidogrel use and mild traumatic intracranial hemorrhage with those without prior use of these medications. METHODS: This was a retrospective study conducted at a Level 1 trauma center from April 2009 to July 2010. Patients older than 55 years with isolated mild head injury (Glasgow Coma Scale score 13-15 and Abbreviated Injury Score < 3 in nonhead body region) were included. Demographic, clinical, and outcome data were abstracted from an existing traumatic brain injury database. The primary end point of unfavorable extended Glasgow Outcome Score at 6 months was compared between patients with and without preinjury warfarin or clopidogrel use. RESULTS: Seventy-seven eligible patients were identified: 27 (35%) with preinjury warfarin or clopidogrel use and 50 (65%) without. Baseline characteristics (sex, Glasgow Coma Scale score, Injury Severity Score, computed tomography score, and in-hospital mortality) were similar between cohorts, although the preinjury warfarin or clopidogrel cohort was older than the control group (P < .05). Patients in the preinjury warfarin or clopidogrel cohort were more likely to have an unfavorable outcome (16/27; 59.3%; 95% confidence interval, 40.7%-77.8%) as compared with those without (18/50; 36.0%; 95% confidence interval, 22.7%-49.3%) (P = .05). CONCLUSION: Older adults with preinjury warfarin or clopidogrel use and mild traumatic intracranial hemorrhage may be at an increased risk for unfavorable long-term neurological outcomes compared with similar patients without preinjury use of these medications.<p /> <p>Language: en</p>",
language="en",
issn="0735-6757",
doi="10.1016/j.ajem.2013.04.035",
url="http://dx.doi.org/10.1016/j.ajem.2013.04.035"
}