Observational studyAnnals of emergency medicine2020
Prevalence of Intracranial Injury in Adult Patients With Blunt Head Trauma With and Without Anticoagulant or Antiplatelet Use.
Observational study in Annals of emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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.
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.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Systematic review on traumatic intracranial haemorrhage in patients on anti-thrombotic medications; haemorrhage progression, thrombosis, and anti-thrombotic recommencement.Neurosurgical review · 2023Pooled it
- Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Mild Traumatic Brain Injury: Approved by ACEP Board of Directors, February 1, 2023 Clinical Policy Endorsed by the Emergency Nurses Association (April 5, 2023).Annals of emergency medicine · 2023Guideline
- Oral anticoagulant use by emergency medical services patients: an observational study.Clinical and experimental emergency medicine · 2025Article
- Article
- Developing a clinical decision tool to support paramedics when assessing and managing children with minor head injury.BMC emergency medicine · 2025Article
- Choice of Antiplatelet vs. Anticoagulant for Blunt Cerebrovascular Injury.Life (Basel, Switzerland) · 2025Review
- Diagnostic performance of S100B assay for intracranial hemorrhage detection in patients with mild traumatic brain injury under antiplatelet or anticoagulant therapy.Scientific reports · 2025Article
- Association of antiplatelet agents and intracranial hemorrhage in geriatric emergency department patients with head trauma from a fall.Trauma surgery & acute care open · 2025Article
- Unequal risks, unchanged practice: antiplatelet therapy and head imaging after geriatric falls.Trauma surgery & acute care open · 2025Article
- Comparative Analysis of Antithrombotic Therapy Outcomes in Mild Traumatic Brain-Injury Patients: A Focus on Bleeding Risk and Hospital-Stay Duration.Life (Basel, Switzerland) · 2024Article
- Use of the Canadian CT head rule for patients on anticoagulant/anti-platelet therapy presenting with mild traumatic brain injury: prospective observational study.Frontiers in neurology · 2024Article
- Cutaneous Impact Location Predicts Intracranial Injury Among the Elderly Population with Traumatic Brain Injury.Open access emergency medicine : OAEM · 2023Article
- The relationship between abnormal intracranial findings in brain computed tomography and antiplatelet or anticoagulant use in patients with nontraumatic headache: a prospective cohort study.Clinical and experimental emergency medicine · 2022Article
- Pre-Injury Antiplatelet Therapy and Risk of Adverse Outcomes after Traumatic Brain Injury: A Systematic Review and Meta-Analysis.Neurotrauma reports · 2022Article
- Intracranial hemorrhage after head injury among older patients on anticoagulation seen in the emergency department: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Impact of Preinjury Antithrombotic Therapy on 30-Day Mortality in Older Patients Hospitalized With Traumatic Brain Injury (TBI).Frontiers in neurology · 2021Article
- Cutaneous impact location: a new tool to predict intracranial lesion among the elderly with mild traumatic brain injury?Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Article
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
STUDY
objectiveWe determine the prevalence of significant intracranial injury among adults with blunt head trauma who are receiving preinjury anticoagulant or antiplatelet medications.
methodsThis was a multicenter, prospective, observational study conducted from December 2007 to December 2015. Patients were enrolled in 3 emergency departments (EDs) in the United States. Adults with blunt head trauma who underwent neuroimaging in the ED were included. Use of preinjury aspirin, clopidogrel, and warfarin was recorded. Data on direct oral anticoagulants were not specifically recorded. The primary outcome was prevalence of significant intracranial injury on neuroimaging. The secondary outcome was receipt of neurosurgical intervention.
resultsAmong 9,070 patients enrolled in this study, the median age was 53.8 years (interquartile range 34.7 to 74.3 years) and 60.7% were men. A total of 1,323 patients (14.6%) were receiving antiplatelet medications or warfarin, including 635 receiving aspirin alone, 109 clopidogrel alone, and 406 warfarin alone. Compared with that of patients without any coagulopathy, the relative risk of significant intracranial injury was 1.29 (95% confidence interval [CI] 0.88 to 1.87) for patients receiving aspirin alone, 0.75 (95% CI 0.24 to 2.30) for those receiving clopidogrel alone, and 1.88 (95% CI 1.28 to 2.75) for those receiving warfarin alone. The relative risk of significant intracranial injury was 2.88 (95% CI 1.53 to 5.42) for patients receiving aspirin and clopidogrel in combination.
conclusionPatients receiving preinjury warfarin or a combination of aspirin and clopidogrel were at increased risk for significant intracranial injury, but not those receiving aspirin alone. Clinicians should have a low threshold for neuroimaging when evaluating patients receiving warfarin or a combination of aspirin and clopidogrel.
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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.