Anticoagulation is Associated with Increased Mortality in Splenic Injuries

Area of Science:

• Trauma surgery
• Emergency medicine
• Clinical outcomes research

Background:

• Anticoagulation (AC) use in trauma patients presents a complex clinical challenge.
• Existing literature on AC's impact on trauma outcomes is conflicting, particularly for splenic injuries.

Purpose of the Study:

• To investigate the effect of anticoagulation on outcomes in adult patients with splenic injuries.
• To compare demographics, comorbidities, hospital course, and outcomes between anticoagulated and non-anticoagulated patients with splenic injury.

Main Methods:

• Analysis of the 2017 Trauma Quality Programs Participant Use File (PUF).
• Inclusion of adult patients (18+ years) with all mechanisms and grades of splenic injury.
• Comparison of outcomes between patients on anticoagulation (AC) versus those not on AC.

Main Results:

• A total of 18,749 patients were analyzed; 622 were on AC.
• Anticoagulated patients had longer hospital stays (median 6.3 vs. 5.6 days) and higher mortality rates (13.3% vs. 7.0%).
• Anticoagulation was identified as an independent risk factor for mortality (OR 1.4, 95% CI: 1.1-1.9).

Conclusions:

• Anticoagulation is associated with increased mortality in patients sustaining splenic injuries.
• The findings highlight a significant risk associated with anticoagulation in this patient population.
• Further research may explore management strategies for anticoagulated patients with splenic trauma.