Papers presented
The effects of preinjury clopidogrel use on older trauma patients with head injuries

Presented at the 58th Annual Meeting of the Southwestern Surgical Congress, Kauai, Hawaii, April 3–7, 2006
https://doi.org/10.1016/j.amjsurg.2006.08.037Get rights and content

Abstract

Background

This study was designed to determine whether or not older trauma patients on clopidogrel have an increased risk of morbidity and mortality.

Methods

A retrospective review was performed on all trauma patients ≥50 years of age between January 1, 2002, and August 31, 2005. The charts of those patients who had documented preinjury use of clopidogrel were further reviewed. A control group of patients with no history of clopidogrel use was matched for age, sex, mechanism of injury, and injury severity score.

Results

During this time period, there were 1,020 trauma patients ≥50 years of age admitted, 43 of which had documented preinjury clopidogrel use (P). A higher percentage of patients in the P group underwent cranial surgery, had episodes of rebleeds, and required transfusions of blood products than in the control group. The mortality and length of stay were comparable in both groups.

Conclusion

This study indicates that the preinjury use of clopidogrel may cause significant morbidity in patients with closed-head injuries. Further studies are needed to suggest specific treatment modalities.

Section snippets

Methods

After obtaining institutional review board approval, a retrospective chart review was performed on all patients greater than 50 years of age who presented to a level 2 trauma center between January 1, 2002, and August 31, 2005. The charts of those patients who had documented preinjury use of clopidogrel were further reviewed. A control group of patients with no history of clopidogrel use was randomly matched for age, sex, mechanism of injury, and Injury Severity Score (ISS). The types of

Results

During this time period, there were a total of 5,875 trauma patients admitted, of which there were 1,020 trauma patients ≥50 years of age. Forty-three patients had documented preinjury clopidogrel use (P). A control group (C) from the patients without previous clopidogrel use was matched based on previously mentioned criteria. Gender (58% male) and age (average age, 73) were similar between the 2 groups. The most common mechanisms of injury in the majority of patients were fall and motor

Comments

Clopidogrel is an antiplatelet medication that inhibits adenosine diphosphate–induced platelet aggregation. It is indicated for patients with recent myocardial infarction, recent stroke, established peripheral arterial disease, and acute coronary syndrome. Because of its reported benefits in decreasing the morbidity of thrombotic events in patients with these conditions, its use has increased over the past several years especially in patients >65 years of age and in patients with coronary

References (10)

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