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  • Mathieu, FrançoisDivision of Neurosurgery, University of Toronto, Toronto, Ontario, Canada; Division of Anesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom (författare)

Impact of Antithrombotic Agents on Radiological Lesion Progression in Acute Traumatic Brain Injury : A CENTER-TBI Propensity-Matched Cohort Analysis

  • Artikel/kapitelEngelska2020

Förlag, utgivningsår, omfång ...

  • Mary Ann Liebert,2020
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:oru-82571
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-82571URI
  • https://doi.org/10.1089/neu.2019.6911DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:143843277URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-179985URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Funding Agencies:Cambridge Commonwealth Trust  Academy of Medical Sciences/The Health Foundation Clinician Scientist Fellowship  National Institute for Health Research (NIHR)
  • An increasing number of elderly patients are being affected by traumatic brain injury (TBI) and a significant proportion are on pre-hospital antithrombotic therapy for cardio- or cerebrovascular indications. We have quantified the impact of antiplatelet/anticoagulant (APAC) agents on radiological lesion progression in acute TBI, using a novel, semi-automated approach to volumetric lesion measurement, and explored the impact of use on clinical outcomes in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. We used a 1:1 propensity-matched cohort design, matching controls to APAC users based on demographics, baseline clinical status, pre-injury comorbidities, and injury severity. Subjects were selected from a pool of patients enrolled in CENTER-TBI with computed tomography (CT) scan at admission and repeated within 7 days of injury. We calculated absolute changes in volume of intraparenchymal, extra-axial, intraventricular, and total intracranial hemorrhage (ICH) between scans, and compared volume of hemorrhagic progression, proportion of patients with significant degree of progression (>25% of initial volume), proportion with new ICH on follow-up CT, as well as clinical course and outcomes. A total of 316 patients were included (158 APAC users; 158 controls). The mean volume of progression was significantly higher in the APAC group for extra-axial (3.1 vs. 1.3 mL, p = 0.01), but not intraparenchymal (3.8 vs. 4.6 mL, p = 0.65), intraventricular (0.2 vs. 0.0 mL, p = 0.79), or total intracranial hemorrhage (ICH; 7.0 vs. 6.0 mL, p = 0.08). More patients had significant hemorrhage growth (54.1 vs. 37.0%, p = 0.003) and delayed ICH (4 of 18 vs. none; p = 0.04) in the APAC group compared with controls, but this was not associated with differences in length of stay (LOS), rates of neurosurgical intervention, mortality or Glasgow Outcome Scale Extended (GOS-E) score at 6 months. Pre-injury use of antithrombotic agents was associated with greater expansion of extra-axial lesions, higher rates of significant hemorrhagic progression, and higher risk of delayed traumatic ICH, but this was not associated with worse clinical course or functional outcomes.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Güting, HelgeInstitute for Research in Operative Medicine (IFOM), Universität Witten/Herdecke, Witten, Germany (författare)
  • Gravesteijn, BenjaminDepartment of Public Health, Erasmus MC, Rotterdam, the Netherlands (författare)
  • Monteiro, MiguelBiomedical Image Analysis Group, Imperial College London, London, United Kingdom (författare)
  • Glocker, BenBiomedical Image Analysis Group, Imperial College London, London, United Kingdom (författare)
  • Kornaropoulos, Evgenios N.Division of Anesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom (författare)
  • Kamnistas, KonstantinosBiomedical Image Analysis Group, Imperial College London, London, United Kingdom (författare)
  • Robertson, Claudia S.Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA (författare)
  • Levin, HarveyDepartment of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA (författare)
  • Whitehouse, Daniel P.Division of Anesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom (författare)
  • Das, TilakDepartment of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom (författare)
  • Lingsma, Hester F.Department of Public Health, Erasmus MC, Rotterdam, the Netherlands (författare)
  • Maegele, MarcInstitute for Research in Operative Medicine (IFOM), Universität Witten/Herdecke, Witten, Germany; Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center, Cologne, Germany (författare)
  • Newcombe, Virginia F. J.Division of Anesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom (författare)
  • Menon, David K.Division of Anesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom (författare)
  • Brorsson, CamillaUmeå universitet,Anestesiologi och intensivvård(Swepub:umu)brca0001 (författare)
  • Oresic, Matej,1967-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)moc(författare)
  • , en Glocker (författare)
  • Koskinen, Lars-Owe D.,1955- (bidragsgivare)
  • Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada; Division of Anesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United KingdomInstitute for Research in Operative Medicine (IFOM), Universität Witten/Herdecke, Witten, Germany (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Journal of Neurotrauma: Mary Ann Liebert37:19, s. 2069-20800897-71511557-9042

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