AUTHOR=Yamaji Fuminori , Okada Hideshi , Kamidani Ryo , Kawasaki Yuki , Yoshimura Genki , Mizuno Yosuke , Kitagawa Yuichiro , Fukuta Tetsuya , Ishihara Takuma , Suzuki Kodai , Miyake Takahito , Kanda Norihide , Doi Tomoaki , Yoshida Takahiro , Yoshida Shozo , Ogura Shinji 

TITLE=Retrospective cohort study to determine the effect of preinjury antiplatelet or anticoagulant therapy on mortality in patients with major trauma

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1089219

DOI=10.3389/fmed.2022.1089219

ISSN=2296-858X

ABSTRACT=Objective: This study aimed to compare outcomes among patients who sustained major trauma from injury with and without receiving antiplatelet therapy (APT) or anticoagulant therapy (ACT) to test the hypothesis that APT does not increase the risk of mortality. However, ACT does in the acute phase of trauma. 
Methods: Patients registered in the Japanese Observational body for Coagulation and Thrombolysis in Early Trauma 2 between April 2017 and March 2018 who had sustained a severe injury in any anatomic region of the body, as determined using an injury severity score ≥ 16 were included in this retrospective cohort study. We analyzed the mortality within 24 h from the arrival using a multivariate linear regression analysis adjusted for several confounding variables. 
Results: We identified 1,186 eligible participants who met the inclusion criteria for this study: 105 in the antiplatelet therapy group (APT) (cases), 1,081 in the non-antiplatelet therapy (nAPT) group (controls), 65 in the anticoagulant therapy (ACT) (cases), and 1,121 in the non-anticoagulant therapy (nACT) group (controls). The mortality within 24 h in the ACT group was significantly higher than in the nACT group (odds ratio 5.32; 95%CI: 1.42 to 19.96; p=0.013); however, there was no significant difference between the two groups regarding antiplatelet drug use (odds ratio 0.73; 95%CI: 0.14 to 3.91; p=0.717).
Conclusion: Regular antiplatelet medications did not increase mortality within 24 h, 28 d, or at discharge in patients with major trauma, suggesting that standard treatment, including surgery, is sufficient.