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Updated: Apr 25, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Dabigatran etixilate and traumatic brain injury: Evolving anticoagulants require evolving care plans
Sam Pakraftar1, Daniela Atencio1, John English1
1Sam Pakraftar, Daniela Atencio, John English, Kurt Stahlfeld, Department of Surgery, UPMC Mercy, Pittsburgh, PA 15219, United States.
Insights
Outcomes for trauma patients with traumatic brain injury (TBI) on Dabigatran Etexilate (DE) are poorly defined. This study found a 21% mortality rate, highlighting the need for management guidelines.
Area of Science:
- Trauma Surgery
- Neurology
- Pharmacology
Background:
- Traumatic brain injury (TBI) management in patients on anticoagulation presents challenges.
- Dabigatran Etexilate (DE) is an anticoagulant with specific considerations in trauma care.
Purpose of the Study:
- To investigate the clinical outcomes of trauma patients with TBI who were taking Dabigatran Etexilate (DE).
Main Methods:
- Retrospective analysis of trauma patients admitted to a level 1 trauma service on DE.
- Evaluation of injury characteristics, length of stay, interventions, and outcomes.
Main Results:
- 28 of 4310 admissions were on DE; 11 excluded due to antiplatelet use.
- Average age 77.14 years, average LOS 4.7 days.
- 32% had intracranial hemorrhage; 21% mortality rate.
Conclusions:
- Managing TBI patients on DE is challenging due to low incidence and lack of guidelines.
- Absence of specific reversal agents complicates care.
- Development of local practice guidelines is recommended.
Aim:
To investigate the outcomes of trauma patients with traumatic brain injury (TBI) on Dabigatran Etexilate (DE).
Methods:
Following IRB approval, all patients taking DE who were admitted to our level 1 trauma service were enrolled in the study. Injury complexity, length of stay (LOS), intensive care length of stay, operative intervention, therapeutic interventions and outcomes were analyzed retrospectively.
Results:
Twenty-eight of 4310 admissions were taking DE. Eleven patients were excluded on concurrent antiplatelet therapy. Average age was 77.14 years (64-94 years), and average LOS was 4.7 d (1-35 d). Thirty-two percent were admitted with intracranial hemorrhage. Eighteen percent received factor VII, and 22% received dialysis in attempts to correct coagulopathy. Mortality was 21%.
Conclusion:
The low incidence, absence of reversal agents, and lack of practice guidelines makes managing patients with TBI taking DE frustrating and provider specific. Local practice guidelines may be helpful in managing such patients.
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