Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation?
This study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM. A 1-year(2017) analysis of the ACS-TQIP. We included all ≥18yrs trauma patients with isolated blunt abdominal-SOI who underwent NOM. Patients were stratified i...
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| Veröffentlicht in: | The American journal of surgery 2022-11, Vol.224 (5), p.1308-1313 |
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| creator | Reina, Raul Anand, Tanya Bhogadi, Sai K. Nelson, Adam Hosseinpour, Hamidreza Ditillo, Michael El-Qawaqzeh, Khaled Castanon, Lourdes Stewart, Collin Joseph, Bellal |
| description | This study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM.
A 1-year(2017) analysis of the ACS-TQIP. We included all ≥18yrs trauma patients with isolated blunt abdominal-SOI who underwent NOM. Patients were stratified into two groups based on their history of pre-injury anticoagulant use. Propensity score matching was performed.
A matched cohort of 2709 patients (AC, 903; No-AC,1806) was analyzed. Compared to the No-AC group, the AC group had higher rates of failure of NOM(2.6% vs. 4.5%, p = 0.03), cardiac arrest (1.2%vs. 3.1%, p = 0.02), acute kidney injury (2.4% vs. 4.2%, p |
| doi_str_mv | 10.1016/j.amjsurg.2022.06.019 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2684104887</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002961022004391</els_id><sourcerecordid>2684104887</sourcerecordid><originalsourceid>FETCH-LOGICAL-c300t-b73b4bcb34a88e46e3ba24b57a08dc8be32b72367df77a257dc2623887d6405d3</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhSMEEkPhEZAssWGT4J_E9rCpqoqWShVs2rV17dwJjhI72EnRPAGvjUfTFZuu7KP7nSPde6rqI6MNo0x-GRuYx7yloeGU84bKhrL9q2rHtNrXTGvxutpRSnm9l4y-rd7lPBbJWCt21d8fMcQFE6z-CckMAQacMawkHoidtvIB28fZB5hIjpPvSUwDBOLDuKXjV3KVkPxBssDRh4FgiNvwi8C6lggfA1ljGa2-qEyKXBKejQTK3EUYtglO4OX76s0Bpowfnt-L6vHm28P19_r-5-3d9dV97QSla22VsK11VrSgNbYShQXe2k4B1b3TFgW3igup-oNSwDvVOy650Fr1sqVdLy6qz-fcJcXfG-bVzD47nCYIGLdsuNQto20xFPTTf-gYt1QOUSglBJOCsq5Q3ZlyKeac8GCW5GdIR8OoOdVjRvNcjznVY6g0pZ7iuzz7sGz75DGZ7MqdHPY-oVtNH_0LCf8AlmieTA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2733163015</pqid></control><display><type>article</type><title>Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation?</title><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Reina, Raul ; Anand, Tanya ; Bhogadi, Sai K. ; Nelson, Adam ; Hosseinpour, Hamidreza ; Ditillo, Michael ; El-Qawaqzeh, Khaled ; Castanon, Lourdes ; Stewart, Collin ; Joseph, Bellal</creator><creatorcontrib>Reina, Raul ; Anand, Tanya ; Bhogadi, Sai K. ; Nelson, Adam ; Hosseinpour, Hamidreza ; Ditillo, Michael ; El-Qawaqzeh, Khaled ; Castanon, Lourdes ; Stewart, Collin ; Joseph, Bellal</creatorcontrib><description>This study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM.
A 1-year(2017) analysis of the ACS-TQIP. We included all ≥18yrs trauma patients with isolated blunt abdominal-SOI who underwent NOM. Patients were stratified into two groups based on their history of pre-injury anticoagulant use. Propensity score matching was performed.
A matched cohort of 2709 patients (AC, 903; No-AC,1806) was analyzed. Compared to the No-AC group, the AC group had higher rates of failure of NOM(2.6% vs. 4.5%, p = 0.03), cardiac arrest (1.2%vs. 3.1%, p = 0.02), acute kidney injury (2.4% vs. 4.2%, p < 0.01), myocardial infarction (0.6% vs. 1.4%,p = 0.03), and mortality (5.1%vs. 7.6%,p = 0.01), and longer hospital LOS (17[10–24]vs.17[12–26]days,p = 0.04) and ICU LOS (11[6–17]vs.11[7–18]days,p = 0.01).
Among nonoperatively managed blunt abdominal SOI patients, preinjury use of anticoagulants negatively impacts outcomes. Extra surveillance is required while managing patients with blunt abdominal SOI on pre-injury anticoagulants.
Level III.
Therapeutic/care management.
[Display omitted]
•The use of direct-acting oral anticoagulants (DOAC) is rising rapidly across the country for the primary and secondary prevention of thromboembolic diseases.•Patients with Blunt abdominal solid organ injury (ASOI) on preinjury chronic anticoagulation could have increased risk of failure of nonoperative management (NOM) due to hemorrhage or other major complications.•Blunt ASOI patients on preinjury anticoagulation have higher rates of failure of NOM, cardiac arrest, AKI, MI, and mortality compared to patients without prior anticoagulation.•Further prospective studies are required to help develop proper management protocols among this subset of trauma patients.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2022.06.019</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>Abdomen ; Adults ; Anticoagulants ; Blunt abdominal injury ; Injuries ; Kidneys ; Mortality ; Myocardial infarction ; Patients ; Preinjury anticoagulation ; Solid organ injury ; Trauma</subject><ispartof>The American journal of surgery, 2022-11, Vol.224 (5), p.1308-1313</ispartof><rights>2022</rights><rights>Copyright Elsevier Limited Nov 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c300t-b73b4bcb34a88e46e3ba24b57a08dc8be32b72367df77a257dc2623887d6405d3</citedby><cites>FETCH-LOGICAL-c300t-b73b4bcb34a88e46e3ba24b57a08dc8be32b72367df77a257dc2623887d6405d3</cites><orcidid>0000-0001-7694-1884 ; 0000-0003-3440-6191 ; 0000-0001-6381-4405 ; 0000-0002-0893-6204 ; 0000-0002-2205-3061</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2733163015?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids></links><search><creatorcontrib>Reina, Raul</creatorcontrib><creatorcontrib>Anand, Tanya</creatorcontrib><creatorcontrib>Bhogadi, Sai K.</creatorcontrib><creatorcontrib>Nelson, Adam</creatorcontrib><creatorcontrib>Hosseinpour, Hamidreza</creatorcontrib><creatorcontrib>Ditillo, Michael</creatorcontrib><creatorcontrib>El-Qawaqzeh, Khaled</creatorcontrib><creatorcontrib>Castanon, Lourdes</creatorcontrib><creatorcontrib>Stewart, Collin</creatorcontrib><creatorcontrib>Joseph, Bellal</creatorcontrib><title>Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation?</title><title>The American journal of surgery</title><description>This study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM.
A 1-year(2017) analysis of the ACS-TQIP. We included all ≥18yrs trauma patients with isolated blunt abdominal-SOI who underwent NOM. Patients were stratified into two groups based on their history of pre-injury anticoagulant use. Propensity score matching was performed.
A matched cohort of 2709 patients (AC, 903; No-AC,1806) was analyzed. Compared to the No-AC group, the AC group had higher rates of failure of NOM(2.6% vs. 4.5%, p = 0.03), cardiac arrest (1.2%vs. 3.1%, p = 0.02), acute kidney injury (2.4% vs. 4.2%, p < 0.01), myocardial infarction (0.6% vs. 1.4%,p = 0.03), and mortality (5.1%vs. 7.6%,p = 0.01), and longer hospital LOS (17[10–24]vs.17[12–26]days,p = 0.04) and ICU LOS (11[6–17]vs.11[7–18]days,p = 0.01).
Among nonoperatively managed blunt abdominal SOI patients, preinjury use of anticoagulants negatively impacts outcomes. Extra surveillance is required while managing patients with blunt abdominal SOI on pre-injury anticoagulants.
Level III.
Therapeutic/care management.
[Display omitted]
•The use of direct-acting oral anticoagulants (DOAC) is rising rapidly across the country for the primary and secondary prevention of thromboembolic diseases.•Patients with Blunt abdominal solid organ injury (ASOI) on preinjury chronic anticoagulation could have increased risk of failure of nonoperative management (NOM) due to hemorrhage or other major complications.•Blunt ASOI patients on preinjury anticoagulation have higher rates of failure of NOM, cardiac arrest, AKI, MI, and mortality compared to patients without prior anticoagulation.•Further prospective studies are required to help develop proper management protocols among this subset of trauma patients.</description><subject>Abdomen</subject><subject>Adults</subject><subject>Anticoagulants</subject><subject>Blunt abdominal injury</subject><subject>Injuries</subject><subject>Kidneys</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Patients</subject><subject>Preinjury anticoagulation</subject><subject>Solid organ injury</subject><subject>Trauma</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc1u1DAUhSMEEkPhEZAssWGT4J_E9rCpqoqWShVs2rV17dwJjhI72EnRPAGvjUfTFZuu7KP7nSPde6rqI6MNo0x-GRuYx7yloeGU84bKhrL9q2rHtNrXTGvxutpRSnm9l4y-rd7lPBbJWCt21d8fMcQFE6z-CckMAQacMawkHoidtvIB28fZB5hIjpPvSUwDBOLDuKXjV3KVkPxBssDRh4FgiNvwi8C6lggfA1ljGa2-qEyKXBKejQTK3EUYtglO4OX76s0Bpowfnt-L6vHm28P19_r-5-3d9dV97QSla22VsK11VrSgNbYShQXe2k4B1b3TFgW3igup-oNSwDvVOy650Fr1sqVdLy6qz-fcJcXfG-bVzD47nCYIGLdsuNQto20xFPTTf-gYt1QOUSglBJOCsq5Q3ZlyKeac8GCW5GdIR8OoOdVjRvNcjznVY6g0pZ7iuzz7sGz75DGZ7MqdHPY-oVtNH_0LCf8AlmieTA</recordid><startdate>202211</startdate><enddate>202211</enddate><creator>Reina, Raul</creator><creator>Anand, Tanya</creator><creator>Bhogadi, Sai K.</creator><creator>Nelson, Adam</creator><creator>Hosseinpour, Hamidreza</creator><creator>Ditillo, Michael</creator><creator>El-Qawaqzeh, Khaled</creator><creator>Castanon, Lourdes</creator><creator>Stewart, Collin</creator><creator>Joseph, Bellal</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7694-1884</orcidid><orcidid>https://orcid.org/0000-0003-3440-6191</orcidid><orcidid>https://orcid.org/0000-0001-6381-4405</orcidid><orcidid>https://orcid.org/0000-0002-0893-6204</orcidid><orcidid>https://orcid.org/0000-0002-2205-3061</orcidid></search><sort><creationdate>202211</creationdate><title>Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation?</title><author>Reina, Raul ; Anand, Tanya ; Bhogadi, Sai K. ; Nelson, Adam ; Hosseinpour, Hamidreza ; Ditillo, Michael ; El-Qawaqzeh, Khaled ; Castanon, Lourdes ; Stewart, Collin ; Joseph, Bellal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c300t-b73b4bcb34a88e46e3ba24b57a08dc8be32b72367df77a257dc2623887d6405d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdomen</topic><topic>Adults</topic><topic>Anticoagulants</topic><topic>Blunt abdominal injury</topic><topic>Injuries</topic><topic>Kidneys</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Patients</topic><topic>Preinjury anticoagulation</topic><topic>Solid organ injury</topic><topic>Trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reina, Raul</creatorcontrib><creatorcontrib>Anand, Tanya</creatorcontrib><creatorcontrib>Bhogadi, Sai K.</creatorcontrib><creatorcontrib>Nelson, Adam</creatorcontrib><creatorcontrib>Hosseinpour, Hamidreza</creatorcontrib><creatorcontrib>Ditillo, Michael</creatorcontrib><creatorcontrib>El-Qawaqzeh, Khaled</creatorcontrib><creatorcontrib>Castanon, Lourdes</creatorcontrib><creatorcontrib>Stewart, Collin</creatorcontrib><creatorcontrib>Joseph, Bellal</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reina, Raul</au><au>Anand, Tanya</au><au>Bhogadi, Sai K.</au><au>Nelson, Adam</au><au>Hosseinpour, Hamidreza</au><au>Ditillo, Michael</au><au>El-Qawaqzeh, Khaled</au><au>Castanon, Lourdes</au><au>Stewart, Collin</au><au>Joseph, Bellal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation?</atitle><jtitle>The American journal of surgery</jtitle><date>2022-11</date><risdate>2022</risdate><volume>224</volume><issue>5</issue><spage>1308</spage><epage>1313</epage><pages>1308-1313</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>This study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM.
A 1-year(2017) analysis of the ACS-TQIP. We included all ≥18yrs trauma patients with isolated blunt abdominal-SOI who underwent NOM. Patients were stratified into two groups based on their history of pre-injury anticoagulant use. Propensity score matching was performed.
A matched cohort of 2709 patients (AC, 903; No-AC,1806) was analyzed. Compared to the No-AC group, the AC group had higher rates of failure of NOM(2.6% vs. 4.5%, p = 0.03), cardiac arrest (1.2%vs. 3.1%, p = 0.02), acute kidney injury (2.4% vs. 4.2%, p < 0.01), myocardial infarction (0.6% vs. 1.4%,p = 0.03), and mortality (5.1%vs. 7.6%,p = 0.01), and longer hospital LOS (17[10–24]vs.17[12–26]days,p = 0.04) and ICU LOS (11[6–17]vs.11[7–18]days,p = 0.01).
Among nonoperatively managed blunt abdominal SOI patients, preinjury use of anticoagulants negatively impacts outcomes. Extra surveillance is required while managing patients with blunt abdominal SOI on pre-injury anticoagulants.
Level III.
Therapeutic/care management.
[Display omitted]
•The use of direct-acting oral anticoagulants (DOAC) is rising rapidly across the country for the primary and secondary prevention of thromboembolic diseases.•Patients with Blunt abdominal solid organ injury (ASOI) on preinjury chronic anticoagulation could have increased risk of failure of nonoperative management (NOM) due to hemorrhage or other major complications.•Blunt ASOI patients on preinjury anticoagulation have higher rates of failure of NOM, cardiac arrest, AKI, MI, and mortality compared to patients without prior anticoagulation.•Further prospective studies are required to help develop proper management protocols among this subset of trauma patients.</abstract><cop>New York</cop><pub>Elsevier Inc</pub><doi>10.1016/j.amjsurg.2022.06.019</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-7694-1884</orcidid><orcidid>https://orcid.org/0000-0003-3440-6191</orcidid><orcidid>https://orcid.org/0000-0001-6381-4405</orcidid><orcidid>https://orcid.org/0000-0002-0893-6204</orcidid><orcidid>https://orcid.org/0000-0002-2205-3061</orcidid></addata></record> |
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| subjects | Abdomen Adults Anticoagulants Blunt abdominal injury Injuries Kidneys Mortality Myocardial infarction Patients Preinjury anticoagulation Solid organ injury Trauma |
| title | Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation? |
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