Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup>
The purpose of this study was to assess anticoagulant medication as an independent factor influencing the occurrence of a severe traumatic brain injury in geriatric patients. Data were collected from the TraumaRegister DGU<sup>®</sup> between January 2015 and December 2018. We included p...
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| Format: | Article |
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MDPI AG
2020-11-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/10/11/842 |
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| author | Nicolas Eibinger Sascha Halvachizadeh Barbara Hallmann Franz Josef Seibert Paul Puchwein Till Berk Rolf Lefering Kai Sprengel Hans Christoph Pape Kai Oliver Jensen The TraumaRegister DGU |
| author_facet | Nicolas Eibinger Sascha Halvachizadeh Barbara Hallmann Franz Josef Seibert Paul Puchwein Till Berk Rolf Lefering Kai Sprengel Hans Christoph Pape Kai Oliver Jensen The TraumaRegister DGU |
| author_sort | Nicolas Eibinger |
| collection | DOAJ |
| description | The purpose of this study was to assess anticoagulant medication as an independent factor influencing the occurrence of a severe traumatic brain injury in geriatric patients. Data were collected from the TraumaRegister DGU<sup>®</sup> between January 2015 and December 2018. We included patients with an age of ≥65 years with a blunt TBI; an AISHead ≥2 but no other relevant injuries. Patients were divided into five subgroups: no anticoagulant medication, anti-platelet drugs, vitamin K antagonists, direct-oral-anticoagulants, and heparinoids. Separation between moderate TBI (AISHead 2–3) and severe TBI (AISHead ≥ 4) and multivariable regression analysis were performed. The average age of 10,559 included patients was 78.8 years with a mean ISS of 16.8 points and a mortality of 22.9%. The most common cause of injury was a low fall of <3 m with 72.8%. With increasing age, the number of patients without any anticoagulant therapy decreased from 65.9% to 29.9%. The intake of coagulation medication increased mortality significantly. Severe TBI was observed in 51% of patients without medication and ranged from 61 to 67% with anticoagulant drugs. After adjusting for confounding variables, the intake of VKA or DOACs was significantly associated with an increased risk of severe TBI. The use of anticoagulant medication is an independent factor and is associated with an increased severity of TBI depending on the type of medication used. |
| first_indexed | 2024-03-10T14:55:28Z |
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| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T14:55:28Z |
| publishDate | 2020-11-01 |
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| series | Brain Sciences |
| spelling | doaj.art-fcf5a268ce73426f80f5ffaf46bb8ad82023-11-20T20:40:09ZengMDPI AGBrain Sciences2076-34252020-11-01101184210.3390/brainsci10110842Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup>Nicolas Eibinger0Sascha Halvachizadeh1Barbara Hallmann2Franz Josef Seibert3Paul Puchwein4Till Berk5Rolf Lefering6Kai Sprengel7Hans Christoph Pape8Kai Oliver Jensen9The TraumaRegister DGU10Division of Trauma Surgery, Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, AustriaDepartment of Trauma, University Hospital Zurich, 8091 Zürich, SwitzerlandDepartment of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, 8036 Graz, AustriaDivision of Trauma Surgery, Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, AustriaDivision of Trauma Surgery, Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, AustriaDepartment of Trauma, University Hospital Zurich, 8091 Zürich, SwitzerlandInstitute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, 58455 Witten, GermanyDepartment of Trauma, University Hospital Zurich, 8091 Zürich, SwitzerlandDepartment of Trauma, University Hospital Zurich, 8091 Zürich, SwitzerlandDepartment of Trauma, University Hospital Zurich, 8091 Zürich, SwitzerlandCommittee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), 80639 Munich, GermanyThe purpose of this study was to assess anticoagulant medication as an independent factor influencing the occurrence of a severe traumatic brain injury in geriatric patients. Data were collected from the TraumaRegister DGU<sup>®</sup> between January 2015 and December 2018. We included patients with an age of ≥65 years with a blunt TBI; an AISHead ≥2 but no other relevant injuries. Patients were divided into five subgroups: no anticoagulant medication, anti-platelet drugs, vitamin K antagonists, direct-oral-anticoagulants, and heparinoids. Separation between moderate TBI (AISHead 2–3) and severe TBI (AISHead ≥ 4) and multivariable regression analysis were performed. The average age of 10,559 included patients was 78.8 years with a mean ISS of 16.8 points and a mortality of 22.9%. The most common cause of injury was a low fall of <3 m with 72.8%. With increasing age, the number of patients without any anticoagulant therapy decreased from 65.9% to 29.9%. The intake of coagulation medication increased mortality significantly. Severe TBI was observed in 51% of patients without medication and ranged from 61 to 67% with anticoagulant drugs. After adjusting for confounding variables, the intake of VKA or DOACs was significantly associated with an increased risk of severe TBI. The use of anticoagulant medication is an independent factor and is associated with an increased severity of TBI depending on the type of medication used.https://www.mdpi.com/2076-3425/10/11/842traumatic brain injurymedicationgeriatricoddsDOAC |
| spellingShingle | Nicolas Eibinger Sascha Halvachizadeh Barbara Hallmann Franz Josef Seibert Paul Puchwein Till Berk Rolf Lefering Kai Sprengel Hans Christoph Pape Kai Oliver Jensen The TraumaRegister DGU Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup> Brain Sciences traumatic brain injury medication geriatric odds DOAC |
| title | Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup> |
| title_full | Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup> |
| title_fullStr | Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup> |
| title_full_unstemmed | Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup> |
| title_short | Is the Regular Intake of Anticoagulative Agents an Independent Risk Factor for the Severity of Traumatic Brain Injuries in Geriatric Patients? A Retrospective Analysis of 10,559 Patients from the TraumaRegister DGU<sup>®</sup> |
| title_sort | is the regular intake of anticoagulative agents an independent risk factor for the severity of traumatic brain injuries in geriatric patients a retrospective analysis of 10 559 patients from the traumaregister dgu sup r sup |
| topic | traumatic brain injury medication geriatric odds DOAC |
| url | https://www.mdpi.com/2076-3425/10/11/842 |
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