edoc

Effect of preoperative antiplatelet or anticoagulation therapy on hemorrhagic complications in patients with traumatic brain injury undergoing craniotomy or craniectomy

Greuter, Ladina and Ullmann, Muriel and Mariani, Luigi and Guzman, Raphael and Soleman, Jehuda. (2019) Effect of preoperative antiplatelet or anticoagulation therapy on hemorrhagic complications in patients with traumatic brain injury undergoing craniotomy or craniectomy. Neurosurg Focus, 47 (5). E3.

Full text not available from this repository.

Official URL: https://edoc.unibas.ch/74424/

Downloads: Statistics Overview

Abstract

Traumatic brain injury (TBI) is common among the elderly, often treated with antiplatelet (AP) or anticoagulation (AC) therapy, creating new challenges in neurosurgery. In contrast to elective craniotomy, in which AP/AC therapy is mostly discontinued, in TBI usually no delay in treatment can be afforded. The aim of this study was to analyze the effect of AP/AC therapy on postoperative bleeding after craniotomy/craniectomy in TBI. Postoperative bleeding rates in patients treated with AP/AC therapy (blood thinner group) and in those without AP/AC therapy (control group) were retrospectively compared. Furthermore, univariate and multivariate analyses were conducted to identify risk factors for postoperative bleeding. Lastly, a proportional Cox regression analysis comparing postoperative bleeding events within 14 days in both groups was performed. Of 143 consecutive patients undergoing craniotomy/craniectomy for TBI between 2012 and 2017, 47 (32.9%) were under AP/AC treatment. No significant difference for bleeding events was observed in univariate (40.4% blood thinner group vs 36.5% control group; p = 0.71) or Cox proportional regression analysis (log rank χ2 = 0.29, p = 0.59). Patients with postoperative bleeding showed a significantly higher mortality rate (p = 0.035). In the univariate analysis, hemispheric lesion, acute subdural hematoma, hematological disease, greater extent of midline shift, and pupillary difference were significantly associated with a higher risk of postoperative bleeding. However, in the multivariate regression analysis none of these factors showed a significant association with postoperative bleeding. Patients treated with AP/AC therapy undergoing craniotomy/craniectomy due to TBI do not appear to have increased rates of postoperative bleeding. Once postoperative bleeding occurs, mortality rates rise significantly.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Kopfbereich > Neurochirurgie (Guzman)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Kopfbereich > Neurochirurgie (Guzman)
03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Kopfbereich > Neurochirurgie (Mariani)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Kopfbereich > Neurochirurgie (Mariani)
UniBasel Contributors:Soleman, Jehuda
Item Type:Article, refereed
Article Subtype:Research Article
Publisher: American Association of Neurological Surgeons
ISSN:
e-ISSN:1092-0684
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:25 Sep 2020 10:38
Deposited On:25 Sep 2020 10:38

Repository Staff Only: item control page