Antithrombotic and risk of hemorrhagic complications in over-60-year-olds after mild-minimal traumatic brain injury

ABSTRACT

Primary objective

to identify if antithombotics are risk factors for intracereral lesion in older adults with minimal-mild traumatic brain injury (m-mTBI)

Research desing

prospective cohort study

Methods and Procedures

We included 2,303 patients over 60 years arriving at our Emergency Department within 24 hours of an mTBI with a Glasgow Coma Scale (GSC) of 14–15. Data were gathered on clinical history, cranial CT scans, blood analyses.

Outcomes and Results

91.1% had an admission GSC score of 15, and 23.6% developed intracranial complications. In bivariate analyses, statins were associated with a 1.28-fold lower risk of IC. Hemorrhagic progression was 29.76-fold higher in patients receiving anticoagulants, with no difference among anticoagulant types. Male sex, GSC of 14, alcohol consumption, and the presence of tumor were risk factors for IC. In multivariate analysis, GSC of 14, alcohol consumption, and malignancy emerged as risk factors for these complications, neurological disease and diabetes as protective factors. After exclusion of neurological disease and diabetes from the multivariate model, a GSC of 14 showed the highest predictive capacity.

Conclusions

Antithrombotics intake are not risks factor for intracranial injury in minimal-mild brain injury trauma. Further research is needed taking account of their fragility and comorbidities.

KEYWORDS:

• Antithrombotics
• minimal-mild traumatic brain injury
• 60 years
• risk factors
• intracranial complications

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.