Platelet dysfunction in patients with traumatic intracranial hemorrhage: Do desmopressin and platelet therapy help or harm? - 15/12/21
, Julia Riccardi a, c , Helen Horng b , Gregory Kacprzynski a, d , Ziad Sifri a Abstract |
Background |
Pre-injury anti-platelet use has been associated with increased risk of progression of traumatic intracranial hemorrhage (TICH) and worse outcomes. VerifyNow® assays assess platelet inhibition due to aspirin/clopidogrel. This study assesses the outcomes of patients with TICH and platelet dysfunction treated with desmopressin and/or platelets.
Methods |
We performed a retrospective chart review of patients with mild TICH at a level 1 trauma center 1/1/2013–6/1/2016. Patients with documented platelet dysfunction who received desmopressin and/or platelets were compared to those who were untreated. Primary outcomes were progression of TICH and neurologic outcomes at discharge.
Results |
Of 565 patients with a mild TICH, 200 patients had evidence of platelet dysfunction (a positive VerifyNow® assay). Patients had similar baseline demographics, injury characteristics, and rate of TICH progression; but patients who received desmopressin and/or platelets had worse Glasgow Outcomes Score at discharge.
Conclusion |
Treatment of patients with mild TICH and platelet dysfunction with desmopressin and/or platelets did not affect TICH progression but correlated with worse neurologic status at discharge.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Traumatic brain injury patients may have worse outcomes if on antiplatelet therapy. |
• | Treating these patients with desmopressin and/or platelets may not improve outcomes. |
• | Further studies to investigate optimal treatment strategies for these patients are warranted. |
Keywords : Traumatic brain injury, Antiplatelet therapy, Outcomes research
Plan
| ☆ | This study was presented at the 33rd Eastern Association for the Surgery of Trauma Annual Assembly in January 2020 in Orlando, FL. |
Vol 223 - N° 1
P. 131-136 - janvier 2022 Retour au numéro
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