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low trauma anticoagulation

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https://www.readbyqxmd.com/read/29618152/altered-plasma-clot-properties-and-trauma-related-venous-thromboembolism-despite-thromboprophylaxis
#1
Sarah Goldman, Paulina Frączek, Krzysztof Szklanny, Elżbieta Papuga-Szela, Andrzej Stanisz, Anetta Undas
BACKGROUND:  Prothrombotic clot phenotype may characterize patients developing deep vein thrombosis (DVT) despite pharmacological thromboprophylaxis. We studied the role of fibrin clot properties and its potential determinants in individuals who experienced DVT after lower limb injury. METHODS:  In a case-control study, we assessed 50 patients who developed DVT despite prophylactic use of low-molecular-weight heparins (the failed thromboprophylaxis group) after a lower limb injury, and three age- and sex-matched control groups, 50 patients each: (1) patients with trauma-related DVT without prior thromboprophylaxis; (2) individuals with unprovoked DVT; (3) patients without history of DVT (the no-DVT controls)...
April 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29580268/the-impact-of-direct-oral-anticoagulants-in-traumatic-brain-injury-patients-greater-than-60-years-old
#2
Oliver Prexl, Martin Bruckbauer, Wolfgang Voelckel, Oliver Grottke, Martin Ponschab, Marc Maegele, Herbert Schöchl
BACKGROUND: Traumatic brain injury (TBI) is the leading cause of death among trauma patients. Patients under antithrombotic therapy (ATT) carry an increased risk for intracranial haematoma (ICH) formation. There is a paucity of data about the role of direct oral anticoagulants (DOACs) among TBI patients. METHODS: In this retrospective study, we investigated all TBI patients ≥60-years-old who were admitted to the intensive care unit (ICU) from January 2014 until May 2017...
March 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29550926/management-of-mild-traumatic-brain-injury-trauma-energy-level-and-medical-history-as-possible-predictors-for-intracranial-hemorrhage
#3
Tomas Vedin, Sebastian Svensson, Marcus Edelhamre, Mathias Karlsson, Mikael Bergenheim, Per-Anders Larsson
PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. METHODS: Medical record data have been collected retrospectively in adult patients with traumatic brain injury...
March 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29541804/evaluation-of-a-protocol-for-early-detection-of-delayed-brain-hemorrhage-in-head-injured-patients-on-warfarin
#4
Jing Li Huang, Theo A Woehrle, Pat Conway, Catherine A McCarty, Madeline M Eyer, Steven D Eyer
PURPOSE: In 2007, Essentia Health St. Mary's Medical Center (SMMC), a Level II trauma center in northeastern Minnesota, implemented a protocol for patients who presented with blunt head trauma and were receiving warfarin for anticoagulation. The purpose of this study was to determine the incidence and risk factors of early delayed, warfarin-associated intracranial hemorrhage (ICH). METHODS: Adult patients with signs and symptoms of head injury on warfarin who were admitted by protocol to SMMC between March 2007 and June 2015 were included...
March 14, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29485294/delayed-intracranial-hemorrhage-in-the-patient-with-blunt-trauma-on-anticoagulant-or-antiplatelet-agents-routine-repeat-head-computed-tomography-is-unnecessary
#5
Joshua H Hill, Paul Bonner, M Shay O'Mara, Teresa Wood, Michael Lieber
OBJECTIVE: We postulate that in patients with blunt trauma on anticoagulant or antiplatelet agents, incidence and complication rate of delayed intracranial hemorrhage (DICH) after an initially negative head CT is low and routine repeat head CT is not warranted. DESIGN: A retrospective, observational study performed from 2008 to 2012. PATIENTS: A total of 338 patients with blunt trauma with pre-admission history of any anticoagulant use, who had an initially negative head CT, followed by a repeat CT within 48 hours...
2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29450470/incidence-of-delayed-intracranial-hemorrhage-in-older-patients-after-blunt-head-trauma
#6
James A Chenoweth, Samuel D Gaona, Mark Faul, James F Holmes, Daniel K Nishijima
Importance: Current guidelines conflict on the management of older adults who have blunt head trauma taking anticoagulant and antiplatelet medications. This is partially due to the limited data comparing patients who are taking these medications with those who are not. Objective: To investigate the incidence of delayed traumatic intracranial hemorrhage in older adults with head trauma, including those taking anticoagulant and antiplatelet medications. Design, Setting, and Participants: This prospective observational cohort study included patients 55 years and older who had blunt head trauma and were transported via emergency medical services between August 1, 2015, and September 30, 2016...
February 14, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29215498/postoperative-deep-vein-thrombosis-pulmonary-embolism-and-myocardial-infarction-complications-after-therapeutic-anticoagulation-in-the-patient-with-spine-trauma
#7
Brian Shiu, Elizabeth Le, Ehsan Jazini, Tristan B Weir, Timothy Costales, Nicholas Caffes, Ebrahim Paryavi, Nathan O'Hara, Daniel E Gelb, Eugene Y Koh, Steven C Ludwig
STUDY DESIGN: A retrospective review (2001-2014) was conducted using prospectively collected data at a level I trauma center. OBJECTIVE: We sought to determine the incidence and characteristics of complications occurring secondary to therapeutic anticoagulation in adult spine trauma patients. SUMMARY OF BACKGROUND DATA: Numerous studies have assessed prophylactic anticoagulation after spine surgery, but none has investigated the risks of therapeutic doses of anticoagulation for treatment of postoperative thromboembolic events...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29121841/prophylactic-inferior-vena-cava-filter-utilization-and-risk-factors-for-nonretrieval
#8
Jordan R Stern, Danielle E Cafasso, Andrew J Meltzer, Darren B Schneider, Sharif H Ellozy, Peter H Connolly
PURPOSE: Inferior vena cava filters (IVCFs) are often placed for prophylactic indications. We sought to better define the range of practice indications for placement of prophylactic IVCFs, as well as the specific retrieval rate and risk factors for nonretrieval. METHODS: A retrospective, single-institution review of patients undergoing IVCF placement over a 2-year period was performed. Patients undergoing prophylactic IVCF placement were selected from a prospectively collected database...
January 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29078871/shedding-new-light-on-rapidly-resolving-traumatic-acute-subdural-hematomas
#9
Magdalene Brooke, Atul Patel, Federico Castro-Moure, Gregory P Victorino
BACKGROUND: Rapidly resolving acute subdural hematomas (RRASDHs) have been described in case reports and case series but are still poorly understood. We hypothesized that a cohort analysis would confirm previously reported predictors of RRASDH including coagulopathy, additional intracranial hemorrhage, and low-density band on imaging. We also hypothesized that rapid resolution would be associated with improved trauma outcomes. METHODS: We reviewed all nonoperative acute subdural hematomas (ASDHs) treated at our center from 2011 to 2015...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28821379/multicenter-trial-of-the-venatech-convertible-vena-cava-filter
#10
MULTICENTER STUDY
Eric J Hohenwalter, James R Stone, Paul V O'Moore, Steven J Smith, J Bayne Selby, Robert J Lewandowski, Shaun Samuels, Paul M Kiproff, David W Trost, David C Madoff, Jeremy Handel, Eric J Gandras, Athanasios Vlahos, William S Rilling
PURPOSE: To demonstrate rates of successful filter conversion and 6-month major device-related adverse events in subjects with converted caval filters. MATERIALS AND METHODS: An investigational device exemption multicenter, prospective, single-arm study was performed at 11 sites enrolling 149 patients. The VenaTech Convertible Vena Cava Filter (B. Braun Interventional Systems, Inc, Bethlehem, Pennsylvania) was implanted in 149 patients with venous thromboembolism and contraindication to or failure of anticoagulation (n = 119), with high-risk trauma (n = 14), and for surgical prophylaxis (n = 16)...
October 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28694001/safety-and-effectiveness-of-argatroban-versus-heparin-for-preventing-venous-thromboembolism-after-lumbar-decompressive-surgery
#11
Ying Guo, Zhongwen Zou, Lianshun Jia, Zhi Huang, Xiong Yun, Guo Xing
BACKGROUND: To evaluate the safety and effectiveness of argatroban for the prevention of venous thromboembolism (VTE) after posterior lumbar decompressive surgery. METHODS: Included in this retrospective study were 556 patients who underwent posterior lumbar decompressive surgery for trauma and degenerative diseases. They were divided into two groups: argatroban group (n = 274), and low molecular weight heparin (LMWH) group (n = 282). The occurrence of postoperative venous thrombosis and complications including hemorrhage and allergic reaction was compared between the two groups...
August 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28642012/evaluation-of-a-device-combining-an-inferior-vena-cava-filter-and-a-central-venous-catheter-for-preventing-pulmonary-embolism-among-critically-ill-trauma-patients
#12
MULTICENTER STUDY
Victor F Tapson, Joshua P Hazelton, John Myers, Claudia Robertson, Ramyar Gilani, Julie A Dunn, Marko Bukur, Martin A Croce, Ann Peick, Sonlee West, Lawrence Lottenberg, Jay Doucet, Preston R Miller, Bruce Crookes, Rajesh R Gandhi, Chasen A Croft, Anthony Manasia, Brian A Hoey, Howard Lieberman, Oscar D Guillamondegui, Victor Novack, Gregory Piazza, Samuel Z Goldhaber
PURPOSE: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients. MATERIALS AND METHODS: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first...
September 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28557861/heartmate-3-in-lowest-intermacs-profile-cohort-the-swiss-experience
#13
Piergiorgio Tozzi, Carlo Banfi, Kameran Ahmadov, Roger Hullin, Philippe Meyer, Raphael Giraud, Lucas Liaudet, Fabrizio Gronchi, Christophe Huber, Matthias Kirsch
New generation devices for long-term mechanical circulatory support are centrifugal pumps having fully magnetically levitated rotors to reduce blood trauma. Recently, the novel HeartMate 3 was cleared for clinical application in Switzerland. In two Swiss University Hospitals part of the "Lausanne-Geneva Transplantation Network," 10 consecutive patients in end-stage heart failure received the HeartMate 3 (Thoratec Corporation, Pleasanton, CA). Device implantation criteria were persistent low output syndrome despite optimal medical treatment...
November 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28541850/repeat-head-ct-not-necessary-for-patients-with-a-negative-initial-head-ct-on-anticoagulation-or-antiplatelet-therapy-suffering-low-altitude-falls
#14
Zachary M Bauman, John M Ruggero, Sunny Squindo, Chris McEachin, Michelle Jaskot, Will Ngo, Scott Barnes, Peter P Lopez
Anticoagulation and antiplatelet (ACAP) medications are increasingly prescribed to patients at high risk for falls. Many trauma centers have developed protocols for obtaining repeat head CT (HCT) for patients with low-altitude falls on ACAP therapy. We assess the need for routine scheduled repeat HCT in this population. Prospective, observational analysis of all low-altitude fall (<6 feet) patients on ACAP therapy evaluated at a Level II trauma center. All low-altitude fall patients with visible or suspected head trauma received an initial HCT...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#15
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28503122/thrombosis-in-inherited-fibrinogen-disorders
#16
REVIEW
Wolfgang Korte, Man-Chiu Poon, Alfonso Iorio, Michael Makris
Although inherited fibrinogen disorders (IFD) are primarily considered to be bleeding disorders, they are associated with a higher thrombotic complication risk than defects in other clotting factors. Managing IFD patients with thrombosis is challenging as anticoagulant treatment may exacerbate the underlying bleeding risk which can be life-threatening. Due to the low prevalence of IFD, there is little information on pathophysiology or optimal treatment of thrombosis in these patients. We searched the literature for cases of thrombosis among IFD patients and identified a total of 128 patient reports...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28475282/risk-of-intracranial-hemorrhage-in-ground-level-fall-with-antiplatelet-or-anticoagulant-agents
#17
Michael Ganetsky, Gregory Lopez, Tara Coreanu, Victor Novack, Steven Horng, Nathan I Shapiro, Kenneth A Bauer
OBJECTIVES: Anticoagulant and antiplatelet medications are known to increase the risk and severity of traumatic intracranial hemorrhage (tICH), even with minor head trauma. Most studies on bleeding propensity with head trauma are retrospective, are based on trauma registries, or include heterogeneous mechanisms of injury. The goal of this study was to determine the rate of tICH from only a common low-acuity mechanism of injury, that of a ground-level fall, in patients taking one or more of the following antiplatelet or anticoagulant medications: aspirin, warfarin, prasugrel, ticagrelor, dabigatran, rivaroxaban, apixaban, or enoxaparin...
October 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28474980/risk-of-deep-venous-thrombosis-in-elective-neurosurgical-procedures-a-prospective-doppler-ultrasound-based-study-in-children-12-years-of-age-or-younger
#18
Andrea G Scherer, Ian K White, Kashif A Shaikh, Jodi L Smith, Laurie L Ackerman, Daniel H Fulkerson
OBJECTIVE The risk of venous thromboembolism (VTE) from deep venous thrombosis (DVT) is significant in neurosurgical patients. VTE is considered a leading cause of preventable hospital deaths and preventing DVT is a closely monitored quality metric, often tied to accreditation, hospital ratings, and reimbursement. Adult protocols include prophylaxis with anticoagulant medications. Children's hospitals may adopt adult protocols, although the incidence of DVT and the risk or efficacy of treatment is not well defined...
July 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28315812/onset-of-coagulation-function-recovery-is-delayed-in-severely-injured-trauma-patients-with-venous-thromboembolism
#19
RANDOMIZED CONTROLLED TRIAL
Belinda H McCully, Christopher R Connelly, Kelly A Fair, John B Holcomb, Erin E Fox, Charles E Wade, Eileen M Bulger, Martin A Schreiber
BACKGROUND: Altered coagulation function after trauma can contribute to development of venous thromboembolism (VTE). Severe trauma impairs coagulation function, but the trajectory for recovery is not known. We hypothesized that enhanced, early recovery of coagulation function increases VTE risk in severely injured trauma patients. STUDY DESIGN: Secondary analysis was performed on data from the Pragmatic Randomized Optimal Platelet and Plasma Ratio (PROPPR) trial, excluding patients who died within 24 hours or were on pre-injury anticoagulants...
July 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28264245/clinical-course-and-results-of-surgery-for-chronic-subdural-hematomas-in-patients-on-drugs-affecting-hemostasis
#20
Tomasz Andrzej Dziedzic, Przemysław Kunert, Andrzej Marchel
OBJECTIVE: An apparent increase of use of drugs affecting hemostasis in our neurosurgical department since the 1990s has encouraged us to investigate whether these drugs influence the clinical course and results of surgery for chronic subdural hematoma (CSDH). METHODS: This retrospective analysis included 178 patients admitted for CSDH from 2007 to 2011 who were divided into two groups: on drugs affecting hemostasis (40; 22%) and no bleeding disorders (138; 78%)...
March 2017: Journal of Korean Neurosurgical Society
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