The impact of antiplatelet drugs on trauma outcomes

2012 ◽  
Vol 73 (2) ◽  
pp. 492-497 ◽  
Author(s):  
Victor A. Ferraris ◽  
Andrew C. Bernard ◽  
Brannon Hyde ◽  
Paul A. Kearney
Keyword(s):  
Antiplatelet Drugs ◽  
Trauma Outcomes ◽  
The Impact

scholarly journals The impact of frailty on trauma outcomes using the Clinical Frailty Scale

2021 ◽  
Author(s):  
Amari Thompson ◽  
Sunil Gida ◽  
Yasar Nassif ◽  
Carla Hope ◽  
Adam Brooks
Keyword(s):  
Clinical Frailty Scale ◽  
Trauma Outcomes ◽  
The Impact

The association of psychiatric and neurological comorbidities with outcomes in traumatic injury patients

2021 ◽  
pp. 009121742198914
Author(s):  
Jennifer Brady ◽  
R David Hayward ◽  
Elango Edhayan
Keyword(s):  
Length Of Stay ◽  
Psychiatric Illness ◽  
Traumatic Injury ◽  
Lower Mortality ◽  
Linear Modeling ◽  
Psychiatric Comorbidities ◽  
Trauma Outcomes ◽  
Hospital Stays ◽  
The Impact ◽  
The Relationship

Introduction Mental illness is a well-known risk factor for injury and injury recidivism. The impact of pre-existing psychiatric illness on trauma outcomes, however, has received less attention. Our study examines the relationship of pre-existing psychiatric illness on trauma outcomes including length of stay, cost, and mortality. Methods Patient data were obtained from the Healthcare Cost and Utilization Project’s State Inpatient Database. All patients admitted for trauma in the Detroit metropolitan area from 1/1/2006 to 12/31/2014 were included. The relationship between individual psychiatric comorbidities (depression, psychosis, and other neurological disorders) and outcomes were evaluated with logistic regression (mortality) and generalized linear modeling (length of stay and cost). Results Over 260,000 records were reviewed. Approximately one-third (29.9%) of patients had one or more psychiatric diagnoses. Patients with depression had longer hospital stays (RR = 1.12, p < 0.001) and higher costs (RR = 1.07, p < 0.001), but also lower mortality (OR = 0.69, p < 0.001). Patients with psychosis had longer stays (RR = 1.18, p < 0.001), higher costs (RR = 1.02, p = 0.002), and lower mortality (OR = 0.61, p < 0.001). Patients with other neurological comorbidities had higher mortality (OR = 1.23, p < 0.001), longer stays (RR = 1.29, p < 0.001), and higher costs (RR = 1.10, p < 0.001). Conclusion Patients with a psychiatric disorder required longer care and incurred greater costs, whereas mortality was higher for only those with a neurological disorder. Identifying patients’ psychiatric comorbidities at the time of admission for trauma may help optimize treatment. Addressing these conditions may help reduce the cost of trauma care.

The impact of transfer on pediatric trauma outcomes

2016 ◽  
Vol 51 (5) ◽  
pp. 843-847 ◽  
Author(s):  
Tiffany Locke ◽  
Janelle Rekman ◽  
Maureen Brennan ◽  
Ahmed Nasr
Keyword(s):  
Pediatric Trauma ◽  
Trauma Outcomes ◽  
The Impact

scholarly journals MP68-14 THE IMPACT OF ANTICOAGULANT AND ANTIPLATELET DRUGS THERAPY ON PERIOPERATIVE OUTCOMES OF PURELY OFF-CLAMP ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY

2020 ◽  
Vol 203 ◽  
pp. e1040
Author(s):  
Umberto Anceschi* ◽  
Aldo Brassetti ◽  
Gabriele Tuderti ◽  
Manuela Costantini ◽  
Riccardo Mastroianni ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Antiplatelet Drugs ◽  
Perioperative Outcomes ◽  
Robotic Assisted ◽  
Robotic Assisted Partial Nephrectomy ◽  
The Impact

The impact of anticoagulation and antiplatelet drugs on the National Optimal Lung Cancer Pathway

Lung Cancer ◽  
2020 ◽  
Vol 139 ◽  
pp. S23
Author(s):  
H. McDill ◽  
M. Hassan ◽  
J. Corcoran ◽  
T. Howell ◽  
C. Daneshvar
Keyword(s):  
Lung Cancer ◽  
Antiplatelet Drugs ◽  
The Impact

scholarly journals The impact of blood type on the mortality of patients with severe abdominal trauma: a multicenter observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wataru Takayama ◽  
Akira Endo ◽  
Kiyoshi Murata ◽  
Kota Hoshino ◽  
Shiei Kim ◽  
...  
Keyword(s):  
Observational Study ◽  
Abdominal Trauma ◽  
Blood Type ◽  
Abbreviated Injury Scale ◽  
Trauma Outcomes ◽  
Multicenter Observational Study ◽  
Transfusion Volume ◽  
Type Of Injury ◽  
The Impact ◽  
The Relationship

AbstractFew studies have investigated the relationship between blood type and trauma outcomes according to the type of injury. We conducted a retrospective multicenter observational study in twelve emergency hospitals in Japan. Patients with isolated severe abdominal injury (abbreviated injury scale for the abdomen ≥ 3 and that for other organs < 3) that occurred between 2008 and 2018 were divided into four groups according to blood type. The association between blood type and mortality, ventilator-free days (VFD), and total transfusion volume were evaluated using univariate and multivariate regression models. A total of 920 patients were included, and were divided based on their blood type: O, 288 (31%); A, 345 (38%); B, 186 (20%); and AB, 101 (11%). Patients with type O had a higher in-hospital mortality rate than those of other blood types (22% vs. 13%, p < 0.001). This association was observed in multivariate analysis (adjusted odds ratio [95% confidence interval] = 1.48 [1.25–2.26], p = 0.012). Furthermore, type O was associated with significantly higher cause-specific mortalities, fewer VFD, and larger transfusion volumes. Blood type O was associated with significantly higher mortality and larger transfusion volumes in patients with isolated severe abdominal trauma.

The Impact of Under-triage on Trauma Outcomes in Older Populations ≥65 Years

2021 ◽  
pp. 000313482095145
Author(s):  
Chelsea M. Knotts ◽  
Milad Modarresi ◽  
Damayanti Samanta ◽  
Bryan K. Richmond
Keyword(s):  
Injury Severity ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Lower Percentage ◽  
Hospital Death ◽  
Trauma Patients ◽  
Discharge Condition ◽  
Trauma Outcomes ◽  
Unfavorable Condition ◽  
The Impact

Background Undertriage of older trauma patients is implicated as a cause for outcome disparities. Undertriage is defined by an Injury Severity Score (ISS) ≥16 without full trauma activation. We hypothesized that in patients ≥65 years, undertriage is associated with unfavorable discharge. Methods This is a retrospective study of patients ≥65 years admitted at a Level 1 Trauma Center between July 2016 and June 2018 with blunt trauma. The Matrix method was used to determine the undertriage rate, and outcomes were compared between undertriaged and fully activated patients with ISS ≥16. Favorable outcomes in undertriaged patients instigated further analyses to determine factors that predicted unfavorable discharge condition, defined by discharge from the hospital with severe disability, persistent vegetative state, and in-hospital death. Results The undertriage rate was 7.9%. When compared to fully activated patients with ISS ≥16, a lower percentage of undertriaged patients were discharged in an unfavorable condition (16.6% vs 64.7%, P < .001). On the multivariate analysis, male sex (OR = 1.52), preexisting coronary artery disease (OR = 1.86), age >90 years (OR = 2.31), ISS 16-25 (OR = 3.50), Glasgow Coma Score (GCS) ≤14 (OR = 6.34), and ISS >25 (OR = 9.64) were significant independent risk factors for unfavorable discharge. Discussion The undertriage rate in patients ≥65 years was higher than the accepted standard (5%). However, undertriaged patients had better outcomes than those fully activated with ISS ≥16. Factors more predictive of unfavorable discharge condition were GCS ≤14 and ISS >25. These data suggest that ISS alone is a poor marker for assessing undertriage in older patients. Additional parameters established in this study should be considered as potential markers for better predicting outcomes in older trauma patients.

Timing of Prophylactic Inferior Vena Cava Filter Placement and Trauma Outcomes

2020 ◽  
pp. 000313482094999
Author(s):  
Adel Elkbuli ◽  
John D. Ehrhardt ◽  
Kyle Kinslow ◽  
Mark McKenney
Keyword(s):  
Inferior Vena Cava ◽  
Hospital Mortality ◽  
Inferior Vena ◽  
Vena Cava ◽  
Trauma Patients ◽  
Filter Placement ◽  
Trauma Outcomes ◽  
Vena Cava Filters ◽  
The Impact ◽  
Post Filter

Background Prophylactic inferior vena cava filters (IVCFs) are often placed in trauma patients who cannot receive prophylactic anticoagulation. IVCFs are utilized in an effort to reduce the risk of acute pulmonary embolism (PE) and mortality. This study aims to investigate whether time-to-filter placement is associated with differences in trauma outcomes. Methods We conducted a single-center retrospective review of adult trauma patients who underwent prophylactic IVCF placement. Patients were divided into 2 groups based on time-to-filter: 0-48 hours and >48 hours. Outcome measures included post-filter deep vein thrombosis (DVT), post-filter PE, in-hospital mortality, and ICU length of stay (ICU-LOS). Significance was defined as P < .05. Results During the 6-year study period, 513 patients underwent prophylactic IVCF placement. Both groups were similar with respect to injury severity score (ISS) ( P = .540), percent of patients on home anticoagulation (38% and 39%, P = .845), abbreviated injury scale (AIS) by anatomic region ( P = .899), and traumatic brain injury (TBI) prevalence ( P = .182). Time-to-filter was not associated with significant differences in DVT, PE, or in-hospital mortality ( P > .05 for all). Filter placement in the first 48 hours was associated with shorter ICU-LOS and hospital-LOS. Conclusions Currently, there are no investigations in the trauma literature looking at the impact of time-to-filter on complications related to venous thromboembolism and potential survival benefit. Results of this investigation showed that IVCF placement within the first 48 hours was significantly associated with shorter ICU- and hospital- LOS.

scholarly journals Is There an Interplay between Immune Checkpoint Inhibitors, Thromboprophylactic Treatments and Thromboembolic Events? Mechanisms and Impact in Non-Small Cell Lung Cancer Patients

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 67
Author(s):  
Federico Nichetti ◽  
Francesca Ligorio ◽  
Emma Zattarin ◽  
Diego Signorelli ◽  
Arsela Prelaj ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Smoking Status ◽  
Prognostic Significance ◽  
Antiplatelet Drugs ◽  
Thromboembolic Events ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

PD-1 pathway blockade has been shown to promote proatherogenic T-cell responses and destabilization of atherosclerotic plaques. Moreover, preclinical evidence suggests a potential synergy of antiplatelet drugs with immune checkpoint inhibitors (ICIs). We conducted an analysis within a prospective observational protocol (APOLLO study) to investigate the rates, predictors, and prognostic significance of thromboembolic events (TE) and thromboprophylaxis in patients with advanced NSCLC treated with ICIs. Among 217 patients treated between April 2014 and September 2018, 13.8% developed TE events. Current smoking status (HR 3.61 (95% CI 1.52–8.60), p = 0.004) and high (>50%) PD-L1 (HR 2.55 (95% CI 1.05–6.19), p = 0.038) resulted in being independent TE predictors. An increased risk of death following a diagnosis of TE (HR 2.93; 95% CI 1.59–5.42; p = 0.0006) was observed. Patients receiving antiplatelet treatment experienced longer progression-free survival (PFS) (6.4 vs. 3.4 months, HR 0.67 (95% CI 0.48–0.92), p = 0.015) and a trend toward better OS (11.2 vs. 9.6 months, HR 0.78 (95% CI 0.55–1.09), p = 0.14), which were not confirmed in a multivariate model. No impact of anticoagulant treatment on patients’ outcomes was observed. NSCLC patients treated with ICIs bear a consistent risk for thrombotic complications, with a detrimental effect on survival. The impact of antiplatelet drugs on ICIs efficacy deserves further investigation in prospective trials.

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