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dc.contributor.authorCollins, Courtney E.
dc.contributor.authorWitkowski, Elan R.
dc.contributor.authorFlahive, Julie
dc.contributor.authorAnderson, Frederick A. Jr.
dc.contributor.authorSantry, Heena
dc.date2022-08-11T08:11:03.000
dc.date.accessioned2022-08-23T17:30:08Z
dc.date.available2022-08-23T17:30:08Z
dc.date.issued2014-10-01
dc.date.submitted2015-01-13
dc.identifier.citation<p>Am J Surg. 2014 Oct;208(4):544-549.e1. doi: 10.1016/j.amjsurg.2014.05.019. <a href="http://dx.doi.org/10.1016/j.amjsurg.2014.05.019">Link to article on publisher's site</a></p>
dc.identifier.issn0002-9610 (Linking)
dc.identifier.doi10.1016/j.amjsurg.2014.05.019
dc.identifier.pmid25129426
dc.identifier.urihttp://hdl.handle.net/20.500.14038/50458
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25129426&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457283/
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAnticoagulants
dc.subjectCraniocerebral Trauma
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectIncidence
dc.subject*Inpatients
dc.subjectInsurance Benefits
dc.subject*Intensive Care Units
dc.subjectIntracranial Hemorrhages
dc.subjectMale
dc.subject*Medicare
dc.subjectPrognosis
dc.subjectRetrospective Studies
dc.subject*Risk Assessment
dc.subjectRisk Factors
dc.subjectSurvival Rate
dc.subjectThromboembolism
dc.subjectUnited States
dc.subjectWarfarin
dc.subjectUMCCTS funding
dc.subjectChemicals and Drugs
dc.subjectClinical Epidemiology
dc.subjectGeriatrics
dc.subjectSurgery
dc.subjectTranslational Medical Research
dc.subjectTrauma
dc.titleEffect of preinjury warfarin use on outcomes after head trauma in Medicare beneficiaries
dc.typeArticle
dc.source.journaltitleAmerican journal of surgery
dc.source.volume208
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/umccts_pubs/31
dc.legacy.embargo2015-01-13T00:00:00-08:00
dc.identifier.contextkey6522109
html.description.abstract<p>BACKGROUND: Elderly Americans are at increased risk of head trauma, particularly fall related. The effect of warfarin on head trauma outcomes remains controversial.</p> <p>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.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathumccts_pubs/31
dc.contributor.departmentGraduate School of Biomedical Sciences
dc.contributor.departmentDepartment of Surgery
dc.source.pages544-549.e1


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