Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients

Abstract 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 m...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Felix M. Bläsius, Markus Laubach, Hagen Andruszkow, Cavan Lübke, Philipp Lichte, Rolf Lefering, Frank Hildebrand, Klemens Horst
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8b4b290f531942c2b94b9158b6d7be9c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8b4b290f531942c2b94b9158b6d7be9c
record_format	dspace
spelling	oai:doaj.org-article:8b4b290f531942c2b94b9158b6d7be9c2021-12-02T16:24:52ZImpact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients10.1038/s41598-021-94675-72045-2322https://doaj.org/article/8b4b290f531942c2b94b9158b6d7be9c2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94675-7https://doaj.org/toc/2045-2322Abstract 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.Felix M. BläsiusMarkus LaubachHagen AndruszkowCavan LübkePhilipp LichteRolf LeferingFrank HildebrandKlemens HorstNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Felix M. Bläsius Markus Laubach Hagen Andruszkow Cavan Lübke Philipp Lichte Rolf Lefering Frank Hildebrand Klemens Horst Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients
description	Abstract 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	article
author	Felix M. Bläsius Markus Laubach Hagen Andruszkow Cavan Lübke Philipp Lichte Rolf Lefering Frank Hildebrand Klemens Horst
author_facet	Felix M. Bläsius Markus Laubach Hagen Andruszkow Cavan Lübke Philipp Lichte Rolf Lefering Frank Hildebrand Klemens Horst
author_sort	Felix M. Bläsius
title	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_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_sort	impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8b4b290f531942c2b94b9158b6d7be9c
work_keys_str_mv	AT felixmblasius impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients AT markuslaubach impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients AT hagenandruszkow impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients AT cavanlubke impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients AT philipplichte impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients AT rolflefering impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients AT frankhildebrand impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients AT klemenshorst impactofanticoagulationandantiplateletdrugsonsurgeryratesandmortalityintraumapatients
_version_	1718384120099241984

Impact of anticoagulation and antiplatelet drugs on surgery rates and mortality in trauma patients

Ejemplares similares