Format

Send to

Choose Destination
Am J Surg. 2014 Oct;208(4):544-549.e1. doi: 10.1016/j.amjsurg.2014.05.019. Epub 2014 Jul 24.

Effect of preinjury warfarin use on outcomes after head trauma in Medicare beneficiaries.

Author information

1
Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
2
Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: Heena.Santry@umassmemorial.org.

Abstract

BACKGROUND:

Elderly Americans are at increased risk of head trauma, particularly fall related. The effect of warfarin on head trauma outcomes remains controversial.

METHODS:

Medicare beneficiaries with head injuries from 2009 to 2011 were identified by International Classification of Diseases (ICD)-9 code. Preinjury warfarin use was determined using Part D claims. Multiple logistic regression models determined the association of preinjury warfarin on need for hospitalization, intensive care unit care, and occurrence of intracranial hemorrhage. Association between warfarin and in-hospital mortality was assessed using a Cox proportional hazard model.

RESULTS:

Of 11,078 head injured patients, 5.2% were injured while on warfarin. Preinjury warfarin increased the odds of intracranial hemorrhage by 40% and doubled the risk of 30-day in-hospital mortality after adjusting for demographic and clinical factors.

CONCLUSIONS:

Warfarin at the time of head injury increases the risk of adverse outcomes in Medicare beneficiaries with head injuries. Caution should be used when initiating anticoagulation in elderly Americans at risk for trauma.

KEYWORDS:

Coumadin; Elderly; Head injury; Intracranial hemorrhage; Trauma; Warfarin

PMID:
25129426
PMCID:
PMC4457283
DOI:
10.1016/j.amjsurg.2014.05.019
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center