Outcomes of anticoagulated trauma patients.

摘要: Patients on warfarin are at high risk for potentially life-threatening hemorrhage even after relatively minor trauma. Outcomes of these patients and the potential complications reversing effects anticoagulation have received little attention. This study was performed to determine overall outcome orally anticoagulated who sustained injury as well any untoward their states. A retrospective injured conducted admitted an urban, university, tertiary-referral, level I trauma center between 1/1/93 12/31/96. Surviving were followed a period least 1 month. Injuries grouped by anatomic site. Charts reviewed degree admission (ie, initial international normalized ratio [INR]), survival, adverse reversal anticoagulation, reinstitution therapy. Discharged contacted home follow-up. Thirty-five consecutive patients, 18 men 17 women, therapy time injuries reviewed. The mean age 75 years, with range 39 96. follow-up 12.7 months. Reasons included atrial fibrillation, prosthetic heart valves, revascularized limb, hypercoagulable state, deep venous thrombosis, pulmonary embolism, phlebitis, aortic stenosis. Mean INR 3.2, 1.6 10.0. There 8 in-hospital deaths. Intracranial hemorrhages accounted majority injuries. Ten not given Four attributable (upper extremity hemiplegia, transient ischemic attack, arterial thrombosis). Twenty-one had reinstituted. Follow-up surviving ranged from 1.5 42 intracranial following may be reversed during acute injury, but arise. Further prospective studies need which require