Retrospective cohort study to determine the effect of preinjury antiplatelet or anticoagulant therapy on mortality in patients with major trauma

Fuminori Yamaji, Hideshi Okada*, Ryo Kamidani, Yuki Kawasaki, Genki Yoshimura, Yosuke Mizuno, Yuichiro Kitagawa, Tetsuya Fukuta, Takuma Ishihara, Kodai Suzuki, Takahito Miyake, Norihide Kanda, Tomoaki Doi, Takahiro Yoshida, Shozo Yoshida, Shinji Ogura

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

抄録

Objective: This study aimed to compare outcomes among patients who sustained major trauma from injury with and without receiving antiplatelet therapy (APT) or anticoagulant therapy (ACT) to test the hypothesis that APT does not increase the risk of mortality. However, ACT increases the mortality risk in the acute phase of trauma. Methods: Patients registered in the Japanese Observational body for Coagulation and Thrombolysis in Early Trauma 2 between April 2017 and March 2018 who had sustained a severe injury in any anatomic region of the body, as determined using an injury severity score (ISS) ≥ 16 were included in this retrospective cohort study. We analyzed the mortality within 24 h from the arrival using a multivariable linear regression analysis adjusted for several confounding variables. Results: We identified 1,186 eligible participants who met the inclusion criteria for this study: 105 in the APT (cases), 1,081 in the non-antiplatelet therapy (nAPT) group (controls), 65 in the ACT (cases), and 1,121 in the non-anticoagulant therapy (nACT) group (controls). The mortality within 24 h in the ACT group was significantly higher than in the nACT group (odds ratio 4.5; 95%CI: 1.2–16.79; p = 0.025); however, there was no significant difference between the two groups with or without the antiplatelet drug (odds ratio 0.32; 95%CI: 0.04–2.79; p = 0.3) administration. Other outcomes, like the 28-day mortality, mortality at discharge, and surgery for hemostasis, were not significantly different between regular users and non-users of either antiplatelet or anticoagulant drugs. Conclusion: Regular antiplatelet medications did not increase mortality within 24 h, 28 days, or at discharge in patients with major trauma, suggesting that standard treatment, including surgery, is sufficient.

本文言語英語
論文番号1089219
ジャーナルFrontiers in Medicine
9
DOI
出版ステータス出版済み - 2023/01/09

ASJC Scopus 主題領域

  • 医学一般

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