Journal article
Geriatric Patients on Antithrombotic Agents Who Fall: Does Trauma Team Activation Improve Outcomes?
The American surgeon, v 85(7), pp 721-724
01 Jul 2019
PMID: 31405415
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Despite the incorporation of anticoagulant and antiplatelet (ACAP) drugs in our trauma triage criteria, it is unclear whether trauma team activation (TTA) impacts outcomes in geriatric patients on ACAP drugs sustaining falls. We hypothesized that TTA in this cohort was associated with improved outcomes. The hospital electronic database was queried to identify normotensive, awake patients aged 65 years on ACAP agent from 2014 to 2018 presenting to the emergency department after falls. The outcome was in-hospital mortality. The association between TTA and mortality was examined using logistic regression analysis and 1:1 propensity score matching analysis. In this study, 4540 patients on ACAP drugs were analyzed, with TTA occurring in 500 (11%). TTA occurred in younger but more severely injured patients with lower Glasgow Coma Score. Logistic regression revealed that TTA was not associated with mortality (odds ratio [95% confidence intervals], 2.04 [0.89-4.25]). The 1: 1 propensity score analysis revealed similar mortality for the matched groups (non-TTA, 1.6% vs TTA, 2.2%, P = 0.64). In the elderly patients on ACAP agents, the current triage criteria resulted in the appropriate use of TTA for more severely injured patients. The lack of outcome benefit suggests that ACAP drug use as a criterion for TTA should be re-evaluated.
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Details
- Title
- Geriatric Patients on Antithrombotic Agents Who Fall: Does Trauma Team Activation Improve Outcomes?
- Creators
- Peter Hwang - Philadelphia College of Osteopathic MedicineAdrian W. Ong - Reading HospitalAlison Muller - Reading HospitalAmanda McNicholas - Reading HospitalAnthony Martin - Reading HospitalAdam Sigal - Reading HospitalForrest B. Fernandez - Philadelphia College of Osteopathic Medicine
- Publication Details
- The American surgeon, v 85(7), pp 721-724
- Publisher
- Sage
- Number of pages
- 4
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000480412200030
- Scopus ID
- 2-s2.0-85071281010
- Other Identifier
- 991022020734504721
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- Web of Science research areas
- Surgery