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The effect anticoagulation status on geriatric fall trauma patients
Julia Coleman1, Mustafa Baldawi1, David Heidt1
1Department of Surgery, University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614, USA.
American Journal of Surgery
|November 28, 2016
Summary
Anticoagulation status impacts outcomes in geriatric fall trauma patients. Clopidogrel use increased mortality and complications, while warfarin use led to longer hospital stays and ICU admissions.
Area of Science:
- Geriatric Trauma Care
- Pharmacology
- Clinical Outcomes Research
Background:
- Geriatric fall trauma patients represent a vulnerable population.
- Anticoagulation is common in this demographic, but its impact on outcomes is not fully understood.
Purpose of the Study:
- To investigate the effect of anticoagulation status on hospital course, complications, and outcomes in geriatric fall trauma patients.
- To compare outcomes among different types of anticoagulation agents.
Main Methods:
- Retrospective cohort study of 1,121 patients aged 60-80 years (2009-2013).
- Analysis stratified by anticoagulation status and type (aspirin, warfarin, clopidogrel, enoxaparin, dipyridamole).
- Outcomes assessed: mortality, length of stay (LOS), intensive care unit (ICU) admission, and complications.
Main Results:
- Patients on anticoagulation had a higher LOS compared to those not on anticoagulation (P = .001).
- Warfarin use was associated with increased LOS and ICU days (P = .001, P = .010).
- Clopidogrel use was linked to higher mortality, LOS, and complication rates (P = .013, P = .036, P = .010).
Conclusions:
- Clopidogrel and warfarin significantly impact outcomes in geriatric fall trauma patients.
- Early identification of high-risk patients on clopidogrel is crucial for closer monitoring.
- Prompt anticoagulation bridging for clopidogrel and warfarin users may prevent prolonged LOS.
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