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入住一级创伤中心的重度创伤患者在受伤前使用口服抗凝药(OAC)或抗血小板治疗(APT)的特征。

The Characteristics of Severely Injured Trauma Patients Admitted to a Level I Trauma Center with Pre-Injury Use of Oral Anticoagulation (OAC) or Antiplatelet Therapy (APT).

作者信息

Weihs Valerie, Antoni Anna, Frenzel Stephan, Aldrian Silke, Hajdu Stefan, Negrin Lukas L

机构信息

Department of Orthopaedics and Trauma Surgery, Division for Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.

出版信息

J Clin Med. 2025 May 21;14(10):3614. doi: 10.3390/jcm14103614.

DOI:10.3390/jcm14103614
PMID:40429609
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12112206/
Abstract

: Little is known about the impact of pre-injury OAC/APT on severely injured trauma patients admitted to a level I trauma center. Our study focused on impact of pre-injury OAC/APT on the outcomes of this specific cohort of patients. : A retrospective cohort study on 356 severely injured trauma patients admitted to the resuscitation room in a level I trauma center between 2015 and 2020 was carried out. : Of the 356 patients, 20.5% (n = 73) were admitted with pre-injury OAC/APT. Falls from lower heights, categorized as low-energy trauma, were the primary mechanism of injury in patients with pre-injury OAC/APT. Patients with pre-injury OAC/APT were older ( < 0.001), had a higher proportion of severe traumatic brain injuries (TBI) ( < 0.001), and experienced significantly higher mortality rates during their hospital stay (60.3% vs. 15.9%; < 0.001). There were significant correlations between pre-injury OAC/APT and advanced age ( < 0.001) as well as the severity of head injury ( < 0.001). Patients with pre-injury OAC/APT exhibited significantly higher mortality rates; especially in patients with pre-injury oral anticoagulation therapy. The highest mortality rates were observed in patients with isolated TBI and pre-injury OAC/APT. : Trauma patients with pre-injury OAC/APT presented with advanced age and low-energy trauma as the main mechanism of injury. Pre-injury OAC/APT significantly correlated with advanced age and the severity of head injuries, and it may serve as an additional prognostic factor for the outcome of severely injured trauma patients.

摘要

关于伤前口服抗凝药/抗血小板治疗(OAC/APT)对入住一级创伤中心的重伤创伤患者的影响,目前所知甚少。我们的研究聚焦于伤前OAC/APT对这一特定患者群体预后的影响。

对2015年至2020年间入住一级创伤中心复苏室的356例重伤创伤患者进行了一项回顾性队列研究。

在这356例患者中,20.5%(n = 73)入院时存在伤前OAC/APT。低能量创伤(归类为从较低高度坠落)是伤前OAC/APT患者的主要损伤机制。伤前OAC/APT患者年龄较大(P < 0.001),重度创伤性脑损伤(TBI)比例较高(P < 0.001),且住院期间死亡率显著更高(60.3% 对15.9%;P < 0.001)。伤前OAC/APT与高龄(P < 0.001)以及头部损伤严重程度(P < 0.001)之间存在显著相关性。伤前OAC/APT患者的死亡率显著更高;尤其是伤前接受口服抗凝治疗的患者。孤立性TBI且伤前OAC/APT的患者死亡率最高。

伤前OAC/APT的创伤患者以高龄和低能量创伤作为主要损伤机制。伤前OAC/APT与高龄和头部损伤严重程度显著相关,它可能是重伤创伤患者预后的一个额外预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/12112206/c792e0cd5714/jcm-14-03614-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/12112206/f3a925594343/jcm-14-03614-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/12112206/89402c5273da/jcm-14-03614-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/12112206/c792e0cd5714/jcm-14-03614-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/12112206/f3a925594343/jcm-14-03614-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/12112206/89402c5273da/jcm-14-03614-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f2c/12112206/c792e0cd5714/jcm-14-03614-g003.jpg

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本文引用的文献

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Eur J Trauma Emerg Surg. 2025 Jan 24;51(1):54. doi: 10.1007/s00068-024-02738-x.
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25 年欧洲 1 级创伤中心成人多发伤患者经验:1995 年至 2019 年多发伤。有何变化?一项回顾性队列研究。
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Mortality in polytrauma patients with moderate to severe TBI on par with isolated TBI patients: TBI as last frontier in polytrauma patients.多发伤合并中重度颅脑损伤患者的死亡率与单纯颅脑损伤患者相当:颅脑损伤是多发伤患者的最后一道难关。
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Eur Geriatr Med. 2022 Feb;13(1):233-241. doi: 10.1007/s41999-021-00546-9. Epub 2021 Jul 29.
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Influence of Oral Anticoagulation and Antiplatelet Drugs on Outcome of Elderly Severely Injured Patients.口服抗凝药和抗血小板药物对老年重伤患者预后的影响。
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