Effect of preinjury warfarin use on outcomes after head trauma in Medicare beneficiaries
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Document Type
Journal ArticlePublication Date
2014-10-01Keywords
AgedAged, 80 and over
Anticoagulants
Craniocerebral Trauma
Female
Follow-Up Studies
Humans
Incidence
*Inpatients
Insurance Benefits
*Intensive Care Units
Intracranial Hemorrhages
Male
*Medicare
Prognosis
Retrospective Studies
*Risk Assessment
Risk Factors
Survival Rate
Thromboembolism
United States
Warfarin
UMCCTS funding
Chemicals and Drugs
Clinical Epidemiology
Geriatrics
Surgery
Translational Medical Research
Trauma
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BACKGROUND: Elderly Americans are at increased risk of head trauma, particularly fall related. The effect of warfarin on head trauma outcomes remains controversial. METHODS: Medicare beneficiaries with head injuries from 2009 to 2011 were identified by International Classification of Diseases (ICD)-9 code. Preinjury warfarin use was determined using Part D claims. Multiple logistic regression models determined the association of preinjury warfarin on need for hospitalization, intensive care unit care, and occurrence of intracranial hemorrhage. Association between warfarin and in-hospital mortality was assessed using a Cox proportional hazard model. RESULTS: Of 11,078 head injured patients, 5.2% were injured while on warfarin. Preinjury warfarin increased the odds of intracranial hemorrhage by 40% and doubled the risk of 30-day in-hospital mortality after adjusting for demographic and clinical factors. CONCLUSIONS: Warfarin at the time of head injury increases the risk of adverse outcomes in Medicare beneficiaries with head injuries. Caution should be used when initiating anticoagulation in elderly Americans at risk for trauma.Source
Am J Surg. 2014 Oct;208(4):544-549.e1. doi: 10.1016/j.amjsurg.2014.05.019. Link to article on publisher's site
DOI
10.1016/j.amjsurg.2014.05.019Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50458PubMed ID
25129426Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/j.amjsurg.2014.05.019