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Microfluidics in Assessing Platelet Function
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Platelet transfusion: an unnecessary risk for mild traumatic brain injury patients on antiplatelet therapy

Chad W Washington1, Douglas J E Schuerer, Robert L Grubb

  • 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. washingtonc@wudosis.wustl.edu

The Journal of Trauma
|August 10, 2011
PubMed
Abstract

Insights

Platelet transfusions did not benefit patients with mild traumatic brain injury and intracranial hemorrhage who were taking antiplatelet agents. Transfusions did not improve outcomes and may increase medical declines.

Area of Science:

  • Neuroscience
  • Trauma Surgery
  • Hematology

Background:

  • Mild traumatic brain injury (MTBI) with intracranial hemorrhage (ICH) is a common injury.
  • Patients on antiplatelet therapy present a unique challenge for management of MTBI with ICH.
  • The role of platelet transfusion in this patient population remains unclear.

Purpose of the Study:

  • To investigate the efficacy of platelet transfusion in patients with MTBI and ICH who were taking antiplatelet agents.
  • To determine if platelet transfusion impacts neurologic decline or head computed tomography progression.

Main Methods:

  • Retrospective review of 321 MTBI patients with ICH admitted to a Level I trauma center over 2 years.
  • Analysis focused on 113 patients taking antiplatelet agents prior to admission.
  • Outcomes assessed included neurologic decline, ICH progression, and Glasgow Outcome Scale.

Main Results:

  • Only 4 (1.2%) of 321 patients experienced neurologic decline, all gradual and non-emergent.
  • No significant difference in ICH progression or neurologic decline was observed between transfused and non-transfused patients taking antiplatelet agents.
  • Any blood product transfusion was a strong predictor of medical decline (OR 5.8, p < 0.0001).

Conclusions:

  • Platelet transfusion does not appear to improve short-term outcomes in MTBI patients with ICH on antiplatelet therapy.
  • Further randomized controlled trials are necessary to definitively assess the benefit of platelet transfusion in this cohort.
  • Given the generally favorable outcomes in MTBI, platelet transfusion may not be indicated.

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