Evidence map›Paper›PMID 36869261›Full record

Observational studyInternal and emergency medicine2023

Minimal is not minor also in patients with mild traumatic brain injury on oral direct anticoagulant therapy.

Alessandro Cipriano, Gianni Turcato, Naria Park, Arian Zaboli, Greta Barbieri, Alessandro Riccardi, Massimo Santini, Roberto Lerza, Antonio Bonora, Lorenzo Ghiadoni

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Internal and emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 47% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Pooled it
  2. Article
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

10 authors at 5 institutions in 1 country.

Alessandro CiprianoEmergency Department, Nuovo Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Gianni TurcatoIntermediate Care Unit, Department of Internal Medicine, Hospital Alto Vicentino, Santorso, Italy.
Naria ParkEmergency Department, Nuovo Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Arian ZaboliEmergency Department, Hospital of Merano (SABES-ASDAA), Via Rossini 5, 39012, Merano, Italy. zaboliarian@gmail.com.ORCID 0000-0002-4204-8884
Greta BarbieriEmergency Department, Nuovo Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Alessandro RiccardiEmergency Department, Hospital of San Paolo (ASL N°2 Savonese), Savona, Italy.
Massimo SantiniEmergency Department, Nuovo Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Roberto LerzaEmergency Department, Hospital of San Paolo (ASL N°2 Savonese), Savona, Italy.
Antonio BonoraEmergency Department, University of Verona, Verona, Italy.
Lorenzo GhiadoniEmergency Department, Nuovo Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Azienda Ospedaliera Universitaria Pisana · ITAzienda Sanitaria Locale N. 2 Savonese · ITUniversity of Pisa · ITKrankenhaus Meran · ITUniversity of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Currently, all patients, regardless of the type of head injury, should undergo a head computerized tomography (CT) if on oral anticoagulant therapy. The aim of the study was to assess the different incidences of intracranial hemorrhage (ICH) between patients with minor head injury (mHI) and patients with mild traumatic brain injury (MTBI) and whether there were differences in the risk of death at 30 days as a result of trauma or neurosurgery. A retrospective multicenter observational study was conducted from January 1, 2016, to February 1, 2020. All patients on DOACs therapy who suffered head trauma and underwent a head CT were extracted from the computerized databases. Patients were divided into two groups MTBI vs mHI all in DOACs treatment. Whether a difference in the incidence of post-traumatic ICH was present was investigated, and pre- and post-traumatic risk factors were compared between the two groups to assess the possible association with ICH risk by propensity score matching. 1425 with an MTBI in DOACs were enrolled. Of these, 80.1% (1141/1425) had an mHI and 19.9% (284/1425) had an MTBI. Of these, 16.5% (47/284) patients with MTBI and 3.3% (38/1141) with mHI reported post-traumatic ICH. After propensity score matching, ICH was consistently found to be more associated with patients with MTBI than with mHI (12.5% vs 5.4%, p = 0.027). Risk factors associated with immediate ICH in mHI patients were high energy impact, previous neurosurgery, trauma above the clavicles, post-traumatic vomiting and headache. Patients on MTBI (5.4%) were found to be more associated with ICH than those with mHI (0.0%, p = 0.002). also when the need for neurosurgery or death within 30 days were considered. Patients on DOACs with mHI have a lower risk of presenting with post-traumatic ICH than patients with MTBI. Furthermore, patients with mHI have a lower risk of death or neurosurgery than patients with MTBI, despite the presence of ICH.

Indexed as

Brain ConcussionCraniocerebral TraumaAnticoagulantsHumansIntracranial HemorrhagesRetrospective StudiesRisk FactorsAnticoagulantsDirect oral anticoagulantsEmergency DepartmentIntracranial hemorrhageMinimal traumatic brain injuryMinor head injuryOral anticoagulants

Identifiers

PMID36869261
OpenAlexW4323049230

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.