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Rethinking the Use of Routine Platelet Transfusions for Head Injured Patients on Antiplatelet Therapy
Gabriel O Ologun1, Arpitha Pamula2, Mojirola Alegbejo-Olarinoye3
1General Surgery, Robert Packer Hospital/Guthrie Clinic, Sayre, USA.
Cureus
|December 31, 2019
Summary
Elderly patients with traumatic brain injury (TBI) on antiplatelet agents face increased intracranial hemorrhage risk. Platelet transfusions, intended to reverse these effects, may paradoxically cause harm, as seen in a fatal case.
Area of Science:
- Neuroscience
- Geriatrics
- Hematology
Background:
- Traumatic brain injury (TBI) affects over a million individuals annually, with aging populations increasing risks.
- Elderly patients often use anticoagulation and antiplatelet agents, complicating TBI management and raising intracranial hemorrhage (ICH) risk.
Observation:
- A case study involving an elderly woman with mild TBI is presented.
- The patient was on antiplatelet therapy, a common scenario in geriatric populations.
Findings:
- Antiplatelet agents significantly elevate the baseline risk of intracranial hemorrhage in TBI patients.
- Routine platelet transfusion to counteract antiplatelet effects may prove detrimental, leading to adverse outcomes.
Implications:
- This case highlights the potential dangers of routine platelet transfusions in TBI patients on antiplatelet therapy.
- Clinical practice may need re-evaluation regarding transfusion protocols for elderly TBI patients using antiplatelet medications.
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