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dc.contributor.authorMathieu, Francois
dc.contributor.authorGüting, Helge
dc.contributor.authorGravesteijn, Benjamin
dc.contributor.authorMonteiro, Miguel
dc.contributor.authorGlocker, Ben
dc.contributor.authorKornaropoulos, Evgenios
dc.contributor.authorKamnistas, Konstantinos
dc.contributor.authorRobertson, Claudia
dc.contributor.authorLevin, Harvey
dc.contributor.authorWhitehouse, Daniel
dc.contributor.authorDas, Tilak
dc.contributor.authorLingsma, Hester F
dc.contributor.authorMaegele, Marc
dc.contributor.authorNewcombe, Virginia F.J.
dc.contributor.authorMenon, David K
dc.contributor.authorAndelic, Nada
dc.contributor.authorAndreassen, Lasse
dc.contributor.authorAnke, Audny
dc.contributor.authorFrisvold, Shirin
dc.contributor.authorHelseth, Eirik
dc.contributor.authorRøe, Cecilie
dc.contributor.authorRøise, Olav
dc.contributor.authorSkandsen, Toril
dc.contributor.authorVik, Anne
dc.contributor.authorÅkerlund, Cecilia
dc.contributor.authorAmrein, Krisztina
dc.contributor.authorAntoni, Anna
dc.contributor.authorAudibert, Gerard
dc.contributor.authorAzouvi, Philippe
dc.contributor.authorAzzolini, Maria Luisa
dc.contributor.authorBartels, Ronald
dc.contributor.authorBarzo, Pal
dc.contributor.authorBeauvais, Romuald
dc.contributor.authorBeer, Ronny
dc.contributor.authorBellander, Bo-Michael
dc.contributor.authorBelli, Antonio
dc.contributor.authorBenali, Habib
dc.contributor.authorBerardino, Maurizio
dc.contributor.authorBeretta, Luigi
dc.contributor.authorBlaabjerg, Morten
dc.contributor.authorBragge, Peter
dc.contributor.authorBrazinova, Alexandra
dc.contributor.authorBrinck, Vibeke
dc.contributor.authorBrooker, Joanne
dc.contributor.authorBrorsson, Camilla
dc.contributor.authorBuki, Andras
dc.contributor.authorBullinger, Monika
dc.contributor.authorCabeleira, Manuel
dc.contributor.authorCaccioppola, Alessio
dc.contributor.authorCalappi, Emiliana
dc.contributor.authorCalvi, Maria Rosa
dc.date.accessioned2021-04-19T13:40:38Z
dc.date.available2021-04-19T13:40:38Z
dc.date.created2021-02-09T14:19:58Z
dc.date.issued2020
dc.identifier.citationJournal of Neurotrauma. 2020, 37 (19), 2069-2080.en_US
dc.identifier.issn0897-7151
dc.identifier.urihttps://hdl.handle.net/11250/2738422
dc.description.abstractAn 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.isoengen_US
dc.publisherMary Ann Lieberten_US
dc.titleImpact of Antithrombotic Agents on Radiological Lesion Progression in Acute Traumatic Brain Injury: A CENTER-TBI Propensity-Matched Cohort Analysisen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.description.versionpublishedVersionen_US
dc.source.pagenumber2069-2080en_US
dc.source.volume37en_US
dc.source.journalJournal of Neurotraumaen_US
dc.source.issue19en_US
dc.identifier.doi10.1089/neu.2019.6911
dc.identifier.cristin1888153
dc.description.localcodeThis article will not be available due to copyright restrictions © 2020 by Mary Ann Liebert, Inc., publishersen_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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