Dabigatran etixilate and traumatic brain injury: Evolving anticoagulants require evolving care plans  

作　　者：Sam Pakraftar Daniela Atencio John English Alain Corcos Eric M Altschuler Kurt Stahlfeld 

机构地区：[1]Department of Surgery,UPMC Mercy,Pittsburgh,PA 15219,United States [2]Department of Trauma and Acute Care Surgery,UPMC Mercy,Pittsburgh,PA 15219,United States [3]Department of Neurosurgery,UPMC Mercy,Pittsburgh,PA 15219,United States

出　　处：《World Journal of Clinical Cases》2014年第8期362-366,共5页世界临床病例杂志

摘　　要：AIM: To investigate the outcomes of trauma patients with traumatic brain injury(TBI) on Dabigatran Etexilate(DE). METHODS: Following IRB approval, all patients taking DE who were admitted to our level 1 trauma service were enrolled in the study. Injury complexity, length of stay(LOS), intensive care length of stay, operative intervention, therapeutic interventions and outcomes were analyzed retrospectively. RESULTS: Twenty-eight of 4310 admissions were taking DE. Eleven patients were excluded on concurrent antiplatelet therapy. Average age was 77.14 years(64-94 years), and average LOS was 4.7 d(1-35 d). Thirty-two percent were admitted with intracranial hemorrhage. Eighteen percent received factor Ⅶ, and 22% received dialysis in attempts to correct coagulopathy. Mortality was 21%.CONCLUSION: The low incidence, absence of reversal agents, and lack of practice guidelines makes managing patients with TBI taking DE frustrating and provider specific. Local practice guidelines may be helpful in managing such patients.AIM: To investigate the outcomes of trauma patients with traumatic brain injury(TBI) on Dabigatran Etexilate(DE). METHODS: Following IRB approval, all patients taking DE who were admitted to our level 1 trauma service were enrolled in the study. Injury complexity, length of stay(LOS), intensive care length of stay, operative intervention, therapeutic interventions and outcomes were analyzed retrospectively. RESULTS: Twenty-eight of 4310 admissions were taking DE. Eleven patients were excluded on concurrent antiplatelet therapy. Average age was 77.14 years(64-94 years), and average LOS was 4.7 d(1-35 d). Thirty-two percent were admitted with intracranial hemorrhage. Eighteen percent received factor Ⅶ, and 22% received dialysis in attempts to correct coagulopathy. Mortality was 21%.CONCLUSION: The low incidence, absence of reversal agents, and lack of practice guidelines makes managing patients with TBI taking DE frustrating and provider specific. Local practice guidelines may be helpful in managing such patients.

关 键 词：DABIGATRAN Brain injury ANTICOAGULATION DABIGATRAN REVERSAL 

分 类 号：R473.6[医药卫生—护理学]