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The effects of preinjury clopidogrel use on older trauma patients with head injuries
Kory Jones1, Collin Sharp, Alicia J Mangram
1Department of Surgery, Methodist Health System, c/o Medical Education Department, 1441 North Beckley Avenue, Dallas, TX 75203, USA.
Insights
Older trauma patients using clopidogrel experienced increased morbidity, particularly with head injuries. However, mortality and hospital stay were similar to controls, suggesting specific risks for this patient group.
Area of Science:
- Trauma Surgery
- Geriatric Medicine
- Pharmacology
Background:
- Investigating the impact of pre-injury clopidogrel use on elderly trauma patients.
- Assessing potential links between clopidogrel and adverse outcomes in trauma care.
Purpose of the Study:
- To determine if older trauma patients on clopidogrel face higher risks of morbidity and mortality.
- To evaluate the specific effects of clopidogrel in geriatric trauma populations.
Main Methods:
- Retrospective review of trauma patients aged 50 and above from 2002-2005.
- Comparison of patients with pre-injury clopidogrel use against a matched control group without clopidogrel history.
- Matching criteria included age, sex, injury mechanism, and Injury Severity Score.
Main Results:
- 43 out of 1,020 elderly trauma patients had documented pre-injury clopidogrel use.
- The clopidogrel group showed higher rates of cranial surgery, re-bleeding episodes, and blood product transfusions.
- No significant differences were observed in mortality rates or length of hospital stay between groups.
Conclusions:
- Pre-injury clopidogrel use may be associated with increased morbidity in elderly trauma patients, especially those with closed-head injuries.
- Further research is warranted to explore specific treatment strategies for these patients.
- The findings highlight potential risks of clopidogrel in specific trauma scenarios.
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 > or =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 > or =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.
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