Background: Although evidence supports the improved safety profile of direct oral anticoagulants (DOACs) over warfarin (WF), outcomes among elderly traumatic brain injury (TBI) patients on this regimen remain unclear. This study describes the association between anticoagulation status (DOAC vs. WF use) and the rates of occurrence of intracranial hemorrhage (ICH), hematoma progression, need for surgical intervention and mortality in elderly TBI cases.
Methods: This retrospective cohort study from 2014 to 2019 included all trauma patients > 65 years on either WF or DOACs at the time of injury. The primary outcome was the rate of ICH after TBI. Multivariable regression analysis identified independent predictors of functional dependency and mortality.
Results: A total of 501 elderly TBI patients (mean age = 82 years old) were included. WF users had higher CT Marshall scores , more severe TBI (GCS < 8) and higher rates of subdural hematomas compared to the DOAC group . Patients on DOACs had lower rates of ICH and hospitalization and better Glasgow outcome scale-extended scores at hospital discharge . Multicompartment ICH and longer hospitalization were associated with higher functional dependency rates, while higher CT Marshall scores and poorer baseline frailty status predicted increased mortality risk.
Conclusion: Elderly TBI patients on DOACs have lower rates of ICH, lower need for hospitalization and better functional outcomes at discharge compared to those taking WF. These findings need further confirmation using prospective multicenter studies.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1017/cjn.2024.347 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Diabetes Risk After Treatment for Childhood and Young Adult Cancer.
Diabetes Care
January 2025
Clinical Population and Sciences Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, U.K.
Objective: Diabetes is a potential late consequence of childhood and young adult cancer (CYAC) treatment. Causative treatments associated with diabetes have been identified in retrospective cohort studies but have not been validated in population-based cohorts. Our aim was to define the extent of diabetes risk and explore contributory factors for its development in survivors of CYAC in the United Kingdom.
View Article and Find Full Text PDFEffects of early propranolol administration on mortality from severe, traumatic brain injury: a retrospective propensity score-matched registry study.
Eur J Trauma Emerg Surg
January 2025
Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
Background: The role of beta-blockers in severe, traumatic brain injury (TBI) management is debated. Severe TBI may elicit a surge of catecholamines, which has been associated with increased morbidity and mortality. We hypothesize administering propranolol, a non-selective beta-blocker, within 48 h of TBI will reduce patient mortality within 30 days of injury.
View Article and Find Full Text PDFD-dimer cutoff values for predicting functional prognosis in patients with severe head trauma: a multi-centre prospective observational study.
Eur J Trauma Emerg Surg
January 2025
Department of Emergency Medicine, Teikyo University of Medicine, 2- 11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan.
Purpose: D-dimer, a fibrinolysis indicator, may predict functional and life outcomes in traumatic brain injury (TBI) patients. We aimed to identify optimal D-dimer cutoff values for poor functional outcomes in severe TBI.
Methods: We used data from a multi-centre prospective observational cohort study that included patients with TBI with a Glasgow Coma Scale (GCS) score ≤ 8 within 48 h after injury or required neurosurgical procedures.
Health and Health Care Utilization Outcomes for Individuals With Traumatic Brain Injury: A 1-Year Longitudinal Study.
J Head Trauma Rehabil
January 2025
Author Affiliations: Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia (Drs Waltzman, Miller, Xu, and Haarbauer-Krupa); and Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana (Dr Hammond).
Objective: Traumatic brain injury (TBI) can result in new onset of comorbidities and limited studies suggest health care utilization following TBI may be high. Setting, Participants, Mean Measures, and Design: This study used 2018 and 2019 MarketScan Commercial Claims and Encounters data to examine differences in longitudinal health outcomes (health care utilization and new diagnoses) by various demographic factors (age, sex, U.S.
View Article and Find Full Text PDFDiffusion Tensor Imaging as Neurologic Predictor in Patients Affected by Traumatic Brain Injury: Scoping Review.
Brain Sci
January 2025
CVJ Operative Unit, CVJ Research Center Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
: Diffusion tensor imaging (DTI), a variant of Diffusion Weighted Imaging (DWI), enables a neuroanatomical microscopic-like examination of the brain, which can detect brain damage using physical parameters. DTI's application to traumatic brain injury (TBI) has the potential to reveal radiological features that can assist in predicting the clinical outcomes of these patients. What is the ongoing role of DTI in detecting brain alterations and predicting neurological outcomes in patients with moderate to severe traumatic brain injury and/or diffuse axonal injury? : A scoping review of the PubMed, Scopus, EMBASE, and Cochrane databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!