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Abstract

The aim of this meta-analysis was to determine the effect and magnitude of effect of pre-injury warfarin on trauma patients. Studies comparing all trauma patients (nb. not head injury patients only) on pre-injury warfarin to all trauma patients not on pre-injury warfarin were included in the meta-analysis. The search was performed using Medline via the PubMed interface; no limits were placed on the language. Ten papers were found to be suitable for the meta-analysis. There were two case control studies and eight retrospective cohort (nested case control) studies. Significant heterogeneity was present as measured by the Q test (Q value = 126.366 df = 9, p = 0.000) and also the I² test (I²= 92.878). The preferred model for this meta-analysis was considered to be the Fixed effect model which produced a common OR 1.952 (95% CI; 1.888–2.018, p = 0.000). The results of this meta-analysis show that pre-injury warfarin does increase mortality in trauma patients by an odds ratio of nearly two.

Keywords

Trauma warfarin anticoagulation mortality meta-analysis adults

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References

Wojcik

Cipolle

Seislove

. Preinjury warfarin does not impact outcome in trauma patients. J Trauma Acute Care Surg 2001; 51: 1147–1152.

Howard

Cipolle

Horvat

. Preinjury warfarin worsens outcome in elderly patients who fall from standing. J Trauma Acute Care Surg 2009; 66: 1518–1522.

Stroup

Berlin

Morton

. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 2000; 283: 2008–2012.

Batchelor

Grayson

. A meta-analysis to determine the effect of anticoagulation on mortality in patients with blunt head trauma. Br J Neurosurg 2012; 26: 525–530.

Bonville

Ata

Jahraus

. Impact of preinjury warfarin and antiplatelet agents on outcomes of trauma patients. Surgery 2011; 150: 861–868.

Dossett

Riesel

Griffin

. Prevalence and implications of preinjury warfarin use: an analysis of the National Trauma Databank. Arch Surg 2011; 146: 565–570.

Patel

Malinoski

Nguyen

. The impact of select chronic diseases on outcomes after trauma: a study from the National Trauma data bank. J Trauma Acute Care Surg 2011; 212: 96–104.

Ferraris

Saha

. The relationship between mortality and pre-existing cardiac disease in 5,971 trauma patients. J Trauma Acute Care Surg 2010; 69: 645–652.

Ott

Ericksson

Vanderkolk

. Antiplatelet and anticoagulation therapies do not increase mortality in the absence of traumatic brain injury. J Trauma Acute Care Surg 2010; 68: 560–563.

10.

Williams

Sadjadi

Harken

. The necessity to assess anticoagulation status in elderly injured patients. J Trauma Acute Care Surg 2008; 65: 772–776.

11.

Pieracci

Eachempati

Shou

. Use of long term anticoagulation is associated with traumatic intracranial haemorrhage and subsequent mortality in elderly patients hospitalized after falls: analysis of the New York State administrative database. J Trauma Acute Care Surg 2007; 63: 519–524.

12.

Kennedy

Cipolle

Pasquale

. Impact of preinjury warfarin use in elderly trauma patients. J Trauma Acute Care Surg 2000; 48: 451–453.

A meta-analysis to determine the effect of pre-injury warfarin on mortality in trauma patients *

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