The Characteristics of Severely Injured Trauma Patients Admitted to a Level I Trauma Center with Pre-Injury Use of Oral Anticoagulation (OAC) or Antiplatelet Therapy (APT)

Background: Little is known about the impact of pre-injury OAC/APT on severely injured trauma patients admitted to a level I trauma center. Our study focused on impact of pre-injury OAC/APT on the outcomes of this specific cohort of patients. Methods: A retrospective cohort study on 356 severely injured trauma patients admitted to the resuscitation room in a level I trauma center between 2015 and 2020 was carried out. Results: Of the 356 patients, 20.5% (n = 73) were admitted with pre-injury OAC/APT. Falls from lower heights, categorized as low-energy trauma, were the primary mechanism of injury in patients with pre-injury OAC/APT. Patients with pre-injury OAC/APT were older (p < 0.001), had a higher proportion of severe traumatic brain injuries (TBI) (p < 0.001), and experienced significantly higher mortality rates during their hospital stay (60.3% vs. 15.9%; p < 0.001). There were significant correlations between pre-injury OAC/APT and advanced age (p < 0.001) as well as the severity of head injury (p < 0.001). Patients with pre-injury OAC/APT exhibited significantly higher mortality rates; especially in patients with pre-injury oral anticoagulation therapy. The highest mortality rates were observed in patients with isolated TBI and pre-injury OAC/APT. Conclusions: Trauma patients with pre-injury OAC/APT presented with advanced age and low-energy trauma as the main mechanism of injury. Pre-injury OAC/APT significantly correlated with advanced age and the severity of head injuries, and it may serve as an additional prognostic factor for the outcome of severely injured trauma patients.