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

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 factorⅦ,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.