According to a study published today, in a three-year study of more than 1,000 patients, adults taking older anticoagulants such as clopidogrel (Plavix) and warfarin (Kumadin) had a skull. We found that there was a significantly higher risk of delayed internal hemorrhage and death after head trauma. At the annual meeting of the Radiological Society of North America (RSNA).Take aspirin at the same time Any Anticoagulants can increase the risk of delayed bleeding.
Intracranial bleeding Occurs when: Blood vessels It ruptures in the brain and releases blood into the brain tissue. With delayed traumatic intracranial hemorrhage, cerebral hemorrhage occurs after the first trauma, usually within 48 hours after the first negative head CT.
High blood pressure, head trauma, and the use of anticoagulants are known causes of intracranial hemorrhage. As the population ages, the prevalence of patients taking anticoagulants is increasing.
“The incidence of delayed intracranial hemorrhage after trauma in patients using different types of anticoagulants, with or without aspirin, is not well established,” said a neuroradiologist. Said Dr. Warrenchan, MD, Head of Research at the Imaging Institute of the Allegheny Health Network. Pennsylvania. “This is an active area of research, especially as new anticoagulants become more widely adopted.”
Adults taking anticoagulants suffering Head injury Usually, you will have CT imaging of the brain. However, standard treatment beyond the initial image is not well defined. Some hospitals allow repeated patient observations and CT imaging, while others may discharge stable patients without intracranial hemorrhage.
“Different hospital networks have different strategies for repeatedly imaging these patients,” said Dr. Chan.
In a retrospective analysis, researchers were taking anticoagulants with head injuries and CT imaging on the Allegheny Health Network between January 1, 2017 and January 1, 2020. We reviewed the records of all patients. Intracranial hemorrhage was negative, followed by repeated imaging tests. The final study group of 1,046 patients included 547 females and 499 males with an average age of 77.5 years.
Within the study group, 576 patients took one of the new anticoagulants such as apixaban (Eliquis), rivaroxaban (Xarelto), and dabigatran (Pradaxa), and 470 patients received warfarin, clopidogrel, or another. I was taking old medicine.
Overall, the incidence of delayed bleeding was 1.91% (20 patients) and the mortality rate was 0.3% (3 patients). All deaths in the study group were among patients in the warfarin / clopidogrel / older anticoagulant group.
Within the entire study group, 345 patients were taking both anticoagulants and aspirin. Of the 20 patients with delayed bleeding, 15 were taking older types of anticoagulants, and 9 of 15 were also taking aspirin.
“Bleeding delay rates were higher in patients taking older anticoagulants compared to new drugs, and significantly higher in patients taking aspirin in addition to older drugs,” Dr. Chan said. ..
Of the five patients taking new anticoagulants who experienced delayed bleeding, four were also taking aspirin.
“Given the large number of trauma patients taking aspirin and anticoagulants, this study guides the care of patients with closed head injuries in emergency medicine and supports efforts to properly use imaging resources. “It helps,” said Dr. Thomas Campbell, MD, of the system. Chair of Emergency Medicine, Allegheny Health Network.
Based on the findings, the authors of the study recommend follow-up CT for patients with no early stages. Intracranial hemorrhage From head injuries taking one of the older anticoagulants, and for patients taking anticoagulants with aspirin. Follow-up CT is not required unless there are external signs of trauma. Patience Those who take only one of the new ones Blood diluent Do not take aspirin.
“Take one blood Thinning at the same time as aspirin significantly increased the risk of delayed bleeding, but I took one of the new drugs without taking it. aspirin The risk has been greatly reduced. “
“This study shows how innovative imaging can drive optimal patient care. Ultimately, we believe that the recommendations in this study will save many lives,” said Allegheny Health Network. Bethany Casagranda DO, Chairman of the Imaging Research Institute, said.
Radiological Society of North America
Quote: A popular anticoagulant is a head injury obtained from https://medicalxpress.com/news/2021-11-popular-blood-thinners-brain-injury.html on November 30, 2021. May cause cerebral bleeding after (November 30, 2021)
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Popular anticoagulants can cause cerebral hemorrhage after head injury
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