Weihs Valerie, Antoni Anna, Frenzel Stephan, Aldrian Silke, Hajdu Stefan, Negrin Lukas L
Department of Orthopaedics and Trauma Surgery, Division for Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2025 May 21;14(10):3614. doi: 10.3390/jcm14103614.
: 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.
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。