The effects of preinjury clopidogrel use on older trauma patients with head injuries

Computed Tomography Use for Adults With Head Injury: Describing Likely Avoidable Emergency Department Imaging Based on the Canadian CT Head Rule

“…We also considered head CTs for trauma patients concordant if any patient was imaged while having a prescription for an anticoagulant medication (warfarin, heparin, clopidogrel, dabigatran, rivaroxaban, or apixaban), as such patients are at higher risk. [21][22][23] These patients were excluded from the original CCHR study and, while this again could lead to some underestimate of the prevalence of nonconcordance, this is not problematic as actual overuse would thus again be at least as high as the prevalence that we are able to determine.…”

Antiplatelet and Anticoagulation Therapies Do Not Increase Mortality in the Absence of Traumatic Brain Injury

“…1 Approximately 1% to 1.5% of the entire population takes the anticoagulant warfarin (Coumadin) with the majority being prescribed to patients older than 65 years, and with the demographics outlined above, that number will only increase. 2 Recently, Jones et al 3 reported that 25% of all traumarelated deaths occur in patients older than 65 years. The inherent danger present to those who take medications such as warfarin after traumatic injury is garnering increased attention.…”

Precordial Steering Wheel: A Fortunate Accident

“…In a retrospective study of patients aged Ͼ 60 years with mild to moderate head trauma, however, there was no association between aspirin use and an increased risk of significant intracranial hemorrhage (13). Conversely, clopidogrel use has been associated with an increased incidence of cranial surgery, episodes of rebleeding, and transfusion requirement among head trauma patients aged Ն 50 years (14). Antithrombin agents, such as enoxaparin, dalteparin, unfractionated heparin, and warfarin, are frequently used in the setting of lower-extremity orthopedic trauma, especially hip fracture, and there is a higher incidence of bleeding associated with their use.…”