Evidence map›Paper›PMID 28526897›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2017

The impact of pre-injury direct oral anticoagulants compared to warfarin in geriatric G-60 trauma patients.

J F Barletta, S Hall, J F Sucher, J K Dzandu, M Haley, A J Mangram

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 20 citations in OpenAlex.

  1. Treatment and outcomes of anticoagulated geriatric trauma patients with traumatic intracranial hemorrhage after falls.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Article
  2. Mortality in relation to presence and type of oral antithrombotic agent among adult trauma patients: a single-center retrospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Article
  3. Article
  4. The impact of direct oral anticoagulants in traumatic brain injury patients greater than 60-years-old.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018
    Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

J F BarlettaCollege of Pharmacy-Glendale, Midwestern University, Glendale, AZ, USA.
S HallDepartment of Pharmacy, Honor Health-John C. Lincoln Medical Center, Phoenix, AZ, USA.
J F SucherTrauma Services and Acute Care Surgery, Honor Health-John C. Lincoln Medical Center, Phoenix, AZ, USA.
J K DzanduTrauma Services and Acute Care Surgery, Honor Health-John C. Lincoln Medical Center, Phoenix, AZ, USA.
M HaleyHonor Health-John C. Lincoln Medical Center, 250 E. Dunlap Ave, Phoenix, AZ, 85020, USA.
A J MangramTrauma Services and Acute Care Surgery, Honor Health-John C. Lincoln Medical Center, Phoenix, AZ, USA. Alicia.mangram@honorhealth.com.
Lincoln Medical Center · USHonorHealth · USMidwestern University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePre-injury oral anticoagulants are associated with worse outcomes in geriatric (G-60) trauma patients, but there are limited data comparing warfarin with direct oral anticoagulants (DOAC). We sought to compare outcomes in G-60 trauma patients taking pre-injury DOACs vs. warfarin.

methodsAll trauma patients, age ≥60 who were admitted to the hospital and taking an oral anticoagulant pre-injury were retrospectively identified. Patients were excluded if their reason for admission was a suicide attempt or penetrating extremity injury. Outcome measures included blood transfusions, hospital LOS, and mortality. A second analysis was performed, whereby patients were matched using ISS and age.

resultsThere were 3,941 patients identified; 331 had documentation of anticoagulant use, pre-injury (warfarin, n = 237; DOAC, n = 94). Demographics were similar, but ISS [9 (4-13) vs. 8 (4-9), p = .027], initial INR [2.2 (1.8-2.9) vs. 1.2 (1.1-1.5), p < .001], and the use of pharmacologic reversal agents (48 vs. 14%, p < .001) were higher in the warfarin group. There was no difference in the use of blood transfusions (24 vs. 17%, p = .164) or mortality (5.9 vs. 4.3%, p = .789) between warfarin and DOAC groups, respectively. However, LOS was longer in the warfarin group [5 (3-7.5) vs. 4 (2-6.3) days, p = .02]. Matched analysis showed no difference in blood transfusions (23 vs. 17%, p = .276), mortality (2.1 vs. 4.3%, p = .682) or LOS [5 (3-7) vs. 4 (2-6.3) days, p = .158] between warfarin and DOAC groups, respectively.

conclusionPre-injury DOACs are not associated with worse clinical outcomes compared to warfarin in G-60 trauma patients. Higher use of pharmacologic reversal agents with warfarin may be related to differences in mechanism of action and effect on INR.

Indexed as

Multiple TraumaAdministration, OralAgedAged, 80 and overAnticoagulantsArizonaCohort StudiesFemaleGlasgow Coma ScaleHemorrhageHumansInjury Severity ScoreInternational Normalized RatioLength of StayMaleRetrospective StudiesAnticoagulantsWarfarinDirect oral anticoagulantPre-injuryTraumaWarfarin

Identifiers

PMID28526897
OpenAlexW2615225192

What OpenQuestion holds

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Registered trials

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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.