Logo image
Back
Anticoagulation Therapy and Severe Traumatic Brain Injury: A Retrospective Cohort Study on Clinical Outcomes Using TriNetX
Journal article   Open access   Peer reviewed

Anticoagulation Therapy and Severe Traumatic Brain Injury: A Retrospective Cohort Study on Clinical Outcomes Using TriNetX

Spencer Thomas Rasmussen, Kamal Shaik, Clayton Rawson, Ammar Saloum, Rudy Rahme and Michael Karsy
Journal of clinical medicine, v 14(13), 4510
25 Jun 2025
DOI: https://doi.org/10.3390/JCM14134510
PMID: 40648883
Featured in Collection :   Research Supported by Drexel Libraries' OA Programs
url
https://doi.org/10.3390/jcm14134510View
Published, Version of Record (VoR)Open Access Discount via Drexel Libraries Read and Publish Program 2025CC BY V4.0,  Open
url
https://doi.org/10.3390/JCM14134510View
Published, Version of Record (VoR) Open

Abstract

severe traumatic brain injury (sTBI) direct oral anticoagulants (DOACs) vitamin K antagonists (VKAs) anticoagulation therapy TriNetX Traumatic Brain Injury
Background: Traumatic brain injury (TBI) is a leading cause of mortality and disability, particularly in patients on anticoagulation therapy. While anticoagulants are linked to higher TBI mortality, the specific impact of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) on severe TBI (sTBI) outcomes remains unclear, especially in light of newer reversal agents. Therefore, this study evaluates long-term mortality and complication risks associated with pre-injury use of DOACs and VKAs in sTBI patients from a large, real-world cohort. Methods: A retrospective cohort study was conducted using the TriNetX global research network, identifying patients with sTBI between 2016 and 2022. Patients were grouped based on pre-injury anticoagulant use: DOAC, VKA, or none. Propensity score matching was performed, adjusting for age, comorbidities, and baseline characteristics. The primary outcome was all-cause mortality at 1-, 3-, 6-, and 12-months post-injury. Secondary outcomes included hospital and surgical complications up to 30 days post-injury. Results: A total of 40,563 patients met the inclusion criteria. At all time intervals, no significant mortality differences were found between the PSM-matched groups. Conclusions: In patients with sTBI, pre-injury DOAC or VKA use was not associated with increased short- or long-term mortality. These findings suggest that, with current perioperative practices, anticoagulation can be managed without adversely affecting outcomes.

Metrics

20 Record Views
1 citations in Web of Science

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Logo image