Does Platelet Administration Affect Mortality in Elderly Head-Injured Patients Taking Antiplatelet Medications?

Douglas M. Downey, Benjamin Monson, Karyn L. Butler, Gerald R. Fortuna, Jonathan M. Saxe, James P. Dolan, Ronald J. Markert, Mary C. McCarthy

Research output: Contribution to journalArticlepeer-review

Abstract

A significant portion of patients sustaining traumatic brain injury (TBI) take antiplatelet medications (aspirin or clopidogrel), which have been associated with increased morbidity and mortality. In an attempt to alleviate the risk of increased bleeding, platelet transfusion has become standard practice in some institutions. This study was designed to determine if platelet transfusion reduces mortality in patients with TBI on antiplatelet medications. Databases from two Level I trauma centers were reviewed. Patients with TBI 50 years of age or older with documented preinjury use of clopidogrel or aspirin were included in our cohort. Patients who received platelet transfusions were compared with those who did not to assess outcome differences between them. Demographics and other patient characteristics abstracted included Injury Severity Score, Glasgow Coma Scale, hospital length of stay, and warfarin use. Three hundred twenty-eight patients comprised the study group. Of these patients, 166 received platelet transfusion and 162 patients did not. Patients who received platelets had a mortality rate of 17.5 per cent (29 of 166), whereas those who did not receive platelets had a mortality rate of 16.7 per cent (27 of 162) ( P = 0.85). Transfusion of platelets in patients with TBI using antiplatelet therapy did not reduce mortality.

Original languageAmerican English
Pages (from-to)1100-1103
Number of pages4
JournalThe American Surgeon
Volume75
Issue number11
DOIs
StatePublished - Nov 1 2009

Keywords

  • Aged
  • Craniocerebral Trauma
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Hemorrhage, Traumatic
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors
  • Platelet Transfusion
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Thrombosis
  • Trauma Severity Indices
  • United States
  • acetylsalicylic acid
  • clopidogrel
  • warfarin

Disciplines

  • Surgery
  • Geriatrics

Cite this