ArticlePrehospital emergency care
Do EMS Providers Accurately Ascertain Anticoagulant and Antiplatelet Use in Older Adults with Head Trauma?
Article in Prehospital emergency care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Medications and patient safety in the trauma setting: a systematic review.World journal of emergency surgery : WJES · 2019Pooled it
- Oral anticoagulant use by emergency medical services patients: an observational study.Clinical and experimental emergency medicine · 2025Article
- Paramedics and emergency medical technicians' perceptions of geriatric trauma care in Saudi Arabia.BMC emergency medicine · 2025Article
- The impacts of ageing-related changes on prehospital trauma care for older adults: challenges and future directions.Frontiers in medicine · 2025Review
- Research priorities for prehospital care of older patients with injuries: scoping review.Age and ageing · 2022Article
- Mild Head Trauma: Is Antiplatelet Therapy a Risk Factor for Hemorrhagic Complications?Medicina (Kaunas, Lithuania) · 2021Article
- Detecting direct oral anticoagulants in trauma patients using liquid chromatography-mass spectrometry: A novel approach to medication reconciliation.The journal of trauma and acute care surgery · 2020Observational
- Out-of-Hospital Triage of Older Adults With Head Injury: A Retrospective Study of the Effect of Adding "Anticoagulation or Antiplatelet Medication Use" as a Criterion.Annals of emergency medicine · 2017Article
- How Well Do EMS Providers Predict Intracranial Hemorrhage in Head-Injured Older Adults?Prehospital emergency careObservational
Corrections and comments
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Authors and funding
17 authors at 8 institutions in 1 country.
Funding
Abstract
objectivePrehospital provider assessment of the use of anticoagulant or antiplatelet medications in older adults with head trauma is important. These patients are at increased risk for traumatic intracranial hemorrhage and therefore field triage guidelines recommend transporting these patients to centers capable of rapid evaluation and treatment. Our objective was to evaluate EMS ascertainment of anticoagulant and antiplatelet medication use in older adults with head trauma.
methodsA retrospective study of older adults with head trauma was conducted throughout Sacramento County. All 5 transporting EMS agencies and all 11 hospitals in the county were included in the study, which ran from January 2012 to December 2012. Patients ≥55 years who were transported to a hospital by EMS after head trauma were included. We excluded patients transferred between two facilities, patients with penetrating head trauma, prisoners, and patients with unmatched hospital data. Anticoagulant and antiplatelet use were categorized as: warfarin, direct oral anticoagulants (DOAC; dabigatran, rivaroxaban, and apixaban), aspirin, and other antiplatelet agents (e.g., clopidogrel and ticagrelor). We calculated the percent agreement and kappa statistic for binary variables between EMS and emergency department (ED)/hospital providers. A kappa statistic ≥0.60 was considered acceptable agreement.
resultsAfter excluding 174 (7.6%) patients, 2,110 patients were included for analysis; median age was 73 years (interquartile range 62-85 years) and 1,259 (60%) were male. Per ED/hospital providers, the use of any anticoagulant or antiplatelet agent was identified in 595 (28.2%) patients. Kappa statistics between EMS and ED/hospital providers for the specific agents were: 0.76 (95% CI 0.71-0.82) for warfarin, 0.45 (95% CI 0.19-0.71) for DOAC agents, 0.33 (95% CI 0.28-0.39) for aspirin, and 0.51 (95% CI 0.42-0.60) for other antiplatelet agents.
conclusionsThe use of antiplatelet or anticoagulant medications in older adults who are transported by EMS for head trauma is common. EMS and ED/hospital providers have acceptable agreement with preinjury warfarin use but not with DOAC, aspirin, and other antiplatelet use.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.