Impact of Antithrombotic Agents on Radiological Lesion Progression in Acute Traumatic Brain Injury: A CENTER-TBI Propensity-Matched Cohort Analysis
dc.contributor.author | Mathieu, Francois | |
dc.contributor.author | Güting, Helge | |
dc.contributor.author | Gravesteijn, Benjamin | |
dc.contributor.author | Monteiro, Miguel | |
dc.contributor.author | Glocker, Ben | |
dc.contributor.author | Kornaropoulos, Evgenios | |
dc.contributor.author | Kamnistas, Konstantinos | |
dc.contributor.author | Robertson, Claudia | |
dc.contributor.author | Levin, Harvey | |
dc.contributor.author | Whitehouse, Daniel | |
dc.contributor.author | Das, Tilak | |
dc.contributor.author | Lingsma, Hester F | |
dc.contributor.author | Maegele, Marc | |
dc.contributor.author | Newcombe, Virginia F.J. | |
dc.contributor.author | Menon, David K | |
dc.contributor.author | Andelic, Nada | |
dc.contributor.author | Andreassen, Lasse | |
dc.contributor.author | Anke, Audny | |
dc.contributor.author | Frisvold, Shirin | |
dc.contributor.author | Helseth, Eirik | |
dc.contributor.author | Røe, Cecilie | |
dc.contributor.author | Røise, Olav | |
dc.contributor.author | Skandsen, Toril | |
dc.contributor.author | Vik, Anne | |
dc.contributor.author | Åkerlund, Cecilia | |
dc.contributor.author | Amrein, Krisztina | |
dc.contributor.author | Antoni, Anna | |
dc.contributor.author | Audibert, Gerard | |
dc.contributor.author | Azouvi, Philippe | |
dc.contributor.author | Azzolini, Maria Luisa | |
dc.contributor.author | Bartels, Ronald | |
dc.contributor.author | Barzo, Pal | |
dc.contributor.author | Beauvais, Romuald | |
dc.contributor.author | Beer, Ronny | |
dc.contributor.author | Bellander, Bo-Michael | |
dc.contributor.author | Belli, Antonio | |
dc.contributor.author | Benali, Habib | |
dc.contributor.author | Berardino, Maurizio | |
dc.contributor.author | Beretta, Luigi | |
dc.contributor.author | Blaabjerg, Morten | |
dc.contributor.author | Bragge, Peter | |
dc.contributor.author | Brazinova, Alexandra | |
dc.contributor.author | Brinck, Vibeke | |
dc.contributor.author | Brooker, Joanne | |
dc.contributor.author | Brorsson, Camilla | |
dc.contributor.author | Buki, Andras | |
dc.contributor.author | Bullinger, Monika | |
dc.contributor.author | Cabeleira, Manuel | |
dc.contributor.author | Caccioppola, Alessio | |
dc.contributor.author | Calappi, Emiliana | |
dc.contributor.author | Calvi, Maria Rosa | |
dc.date.accessioned | 2021-04-19T13:40:38Z | |
dc.date.available | 2021-04-19T13:40:38Z | |
dc.date.created | 2021-02-09T14:19:58Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Journal of Neurotrauma. 2020, 37 (19), 2069-2080. | en_US |
dc.identifier.issn | 0897-7151 | |
dc.identifier.uri | https://hdl.handle.net/11250/2738422 | |
dc.description.abstract | 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. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Mary Ann Liebert | en_US |
dc.title | Impact of Antithrombotic Agents on Radiological Lesion Progression in Acute Traumatic Brain Injury: A CENTER-TBI Propensity-Matched Cohort Analysis | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.source.pagenumber | 2069-2080 | en_US |
dc.source.volume | 37 | en_US |
dc.source.journal | Journal of Neurotrauma | en_US |
dc.source.issue | 19 | en_US |
dc.identifier.doi | 10.1089/neu.2019.6911 | |
dc.identifier.cristin | 1888153 | |
dc.description.localcode | This article will not be available due to copyright restrictions © 2020 by Mary Ann Liebert, Inc., publishers | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 |