Abstract
Previous studies have shown that anticoagulation is associated with a higher risk of bleeding after traumatic brain injury (TBI) and a higher mortality rate. However, other studies have shown conflicting results on the outcome after a TBI in anticoagulated patients. The purpose of this study is to investigate the effect of risk factors including international normalized ratio (INR) as well as the Partial thromboplastin time (PTT) scores on outcome following TBI in the elderly population. Data were retrospectively collected on patients (n = 982) aged 65 and above who were admitted post TBI to the McGill University Health Centre-Montreal General Hospital from 2000 to 2011. Age, Injury Severity Score (ISS), Glasgow Coma Scale score (GCS), type of trauma (isolated TBI vs polytrauma including TBI), initial CT scan results according to the Marshall classification and the INR and PTT scores and prescriptions of antiplatelet or anticoagulant agents (AP/AC) were collected. We found that age is significantly associated with an increase in the rate of death (CSHR:1.08, 95%CI(1.06, 1.11) and in the rate of discharge to a long-term facility (CSHR:1.06, 95%CI (1.03, 1.09)). PTT values above 60 adversely affected outcome in patients not on AP/AC only, and INR values had no effect on outcome or CT findings. Age and injury severity rather than antithrombotic agent intake are associated with adverse acute outcome in hospitalized elderly TBI patients.