@article{ref1,
title="Risk factors associated with intracranial bleeding and neurosurgery in patients with mild traumatic brain injury who are receiving direct oral anticoagulants",
journal="American journal of emergency medicine",
year="2020",
author="Turcato, Gianni and Zaboli, Arian and Zannoni, Massimo and Ricci, Giorgio and Zorzi, Elisabetta and Ciccariello, Laura and Tenci, Andrea and Pfeifer, Norbert and Maccagnani, Antonio and Bonora, Antonio",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: The established clinical risk factors for post-traumatic intracranial bleeding have not been evaluated in patients receiving DOACs yet. <br><br>AIM: Evaluating the association between clinic and patient characteristics and post-traumatic intracranial bleeding (ICH) in patients with mild traumatic brain injury (MTBI) and DOACs. <br><br>METHODS: This is a retrospective observational study conducted on three Emergency Departments. Multivariate analysis provided association in terms of OR with the risk of ICH. The performance of the multivariate model, described in a nomogram, has been tested with discrimination and decision curve analysis. <br><br>RESULTS: Of 473 DOACs patients with MTBI, 8.5% had post-traumatic ICH. On multivariable analysis, major dynamics (odds ratio [OR] 6.255), post-traumatic amnesia (OR 3.961), post-traumatic loss of consciousness (LOC, OR 7.353), Glasgow Coma Scale (GCS) score < 15 (OR 3.315), post-traumatic headache (OR 4.168) and visible trauma above the clavicles (OR 3.378) were associated with a higher likelihood of ICH. The multivariate model, used for the nomogram construction, showed a good performance (AUC bias corrected with 5000 bootstraps resample 0.78). The DCAs showed a net clinical benefit of the prognostic model. <br><br>CONCLUSIONS: Clinical risk factors can be used in DOACs patients to better define the risk of post-traumatic ICH.<br><br>Copyright © 2020 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0735-6757",
doi="10.1016/j.ajem.2020.02.046",
url="http://dx.doi.org/10.1016/j.ajem.2020.02.046"
}