Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: A prospective study

Bellal Joseph, Hassan Aziz, Viraj Pandit, Narong Kulvatunyou, Terence OKeeffe, Andrew Tang, Julie Wynne, Ammar Hashmi, Gary Vercruysse, Randall S. Friese, Peter Rhee

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background Most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate the utility of repeat head computed tomography (RHCT) and outcomes in patients on low-dose aspirin (acetylsalicylic acid; ASA) therapy. Methods Patients with traumatic brain injury with intracranial hemorrhage on initial head computed tomography (CT) were prospectively enrolled. Patients on prehospital low-dose (81 mg) aspirin therapy were matched with patients exclusive of antiplatelet and anticoagulation therapy using propensity score matching in a 1:1 ratio for age, Glasgow Coma Scale, head Abbreviated Injury Scale score, Injury Severity Score, and neurological examination. Outcome measures were progression on RHCT and subsequent neurosurgical intervention. Results A total of 144 patients who had intracranial hemorrhage on initial CT scan (ASA group: 72; No-ASA group: 72) were enrolled. The mean age was 72.8 ± 11.7 years, 59.7% were male, and median head Abbreviated Injury Scale was 3 (2-3). There was no difference in progression on RHCT (25% in ASA versus 16.6% in no-ASA), change in management as a result of RHCT (1.4% versus 1.4%), RHCT as a result of neurological decline (0 versus 1.4%), discharge Glasgow Coma Scale (15 [14-15] versus 15 [14-15]), and mortality (0 versus 1.4%) between the two groups. Conclusions Low-dose aspirin therapy is not associated with progression of initial insult on RHCT or clinical deterioration. Prehospital low-dose aspirin therapy as a sole criterion should not warrant a routine repeat head CT in traumatic brain injury.

Original languageEnglish (US)
Pages (from-to)287-291
Number of pages5
JournalJournal of Surgical Research
Volume186
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Aspirin
Head
Tomography
Prospective Studies
Abbreviated Injury Scale
Glasgow Coma Scale
Therapeutics
Intracranial Hemorrhages
Craniocerebral Trauma
Traumatic Brain Injury
Propensity Score
Injury Severity Score
Platelet Aggregation Inhibitors
Neurologic Examination
Outcome Assessment (Health Care)
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury : A prospective study. / Joseph, Bellal; Aziz, Hassan; Pandit, Viraj; Kulvatunyou, Narong; OKeeffe, Terence; Tang, Andrew; Wynne, Julie; Hashmi, Ammar; Vercruysse, Gary; Friese, Randall S.; Rhee, Peter.

In: Journal of Surgical Research, Vol. 186, No. 1, 01.01.2014, p. 287-291.

Research output: Contribution to journalArticle

Joseph, B, Aziz, H, Pandit, V, Kulvatunyou, N, OKeeffe, T, Tang, A, Wynne, J, Hashmi, A, Vercruysse, G, Friese, RS & Rhee, P 2014, 'Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: A prospective study', Journal of Surgical Research, vol. 186, no. 1, pp. 287-291. https://doi.org/10.1016/j.jss.2013.08.009
Joseph, Bellal ; Aziz, Hassan ; Pandit, Viraj ; Kulvatunyou, Narong ; OKeeffe, Terence ; Tang, Andrew ; Wynne, Julie ; Hashmi, Ammar ; Vercruysse, Gary ; Friese, Randall S. ; Rhee, Peter. / Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury : A prospective study. In: Journal of Surgical Research. 2014 ; Vol. 186, No. 1. pp. 287-291.
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abstract = "Background Most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate the utility of repeat head computed tomography (RHCT) and outcomes in patients on low-dose aspirin (acetylsalicylic acid; ASA) therapy. Methods Patients with traumatic brain injury with intracranial hemorrhage on initial head computed tomography (CT) were prospectively enrolled. Patients on prehospital low-dose (81 mg) aspirin therapy were matched with patients exclusive of antiplatelet and anticoagulation therapy using propensity score matching in a 1:1 ratio for age, Glasgow Coma Scale, head Abbreviated Injury Scale score, Injury Severity Score, and neurological examination. Outcome measures were progression on RHCT and subsequent neurosurgical intervention. Results A total of 144 patients who had intracranial hemorrhage on initial CT scan (ASA group: 72; No-ASA group: 72) were enrolled. The mean age was 72.8 ± 11.7 years, 59.7{\%} were male, and median head Abbreviated Injury Scale was 3 (2-3). There was no difference in progression on RHCT (25{\%} in ASA versus 16.6{\%} in no-ASA), change in management as a result of RHCT (1.4{\%} versus 1.4{\%}), RHCT as a result of neurological decline (0 versus 1.4{\%}), discharge Glasgow Coma Scale (15 [14-15] versus 15 [14-15]), and mortality (0 versus 1.4{\%}) between the two groups. Conclusions Low-dose aspirin therapy is not associated with progression of initial insult on RHCT or clinical deterioration. Prehospital low-dose aspirin therapy as a sole criterion should not warrant a routine repeat head CT in traumatic brain injury.",
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T2 - A prospective study

AU - Joseph, Bellal

AU - Aziz, Hassan

AU - Pandit, Viraj

AU - Kulvatunyou, Narong

AU - OKeeffe, Terence

AU - Tang, Andrew

AU - Wynne, Julie

AU - Hashmi, Ammar

AU - Vercruysse, Gary

AU - Friese, Randall S.

AU - Rhee, Peter

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Y1 - 2014/1/1

N2 - Background Most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate the utility of repeat head computed tomography (RHCT) and outcomes in patients on low-dose aspirin (acetylsalicylic acid; ASA) therapy. Methods Patients with traumatic brain injury with intracranial hemorrhage on initial head computed tomography (CT) were prospectively enrolled. Patients on prehospital low-dose (81 mg) aspirin therapy were matched with patients exclusive of antiplatelet and anticoagulation therapy using propensity score matching in a 1:1 ratio for age, Glasgow Coma Scale, head Abbreviated Injury Scale score, Injury Severity Score, and neurological examination. Outcome measures were progression on RHCT and subsequent neurosurgical intervention. Results A total of 144 patients who had intracranial hemorrhage on initial CT scan (ASA group: 72; No-ASA group: 72) were enrolled. The mean age was 72.8 ± 11.7 years, 59.7% were male, and median head Abbreviated Injury Scale was 3 (2-3). There was no difference in progression on RHCT (25% in ASA versus 16.6% in no-ASA), change in management as a result of RHCT (1.4% versus 1.4%), RHCT as a result of neurological decline (0 versus 1.4%), discharge Glasgow Coma Scale (15 [14-15] versus 15 [14-15]), and mortality (0 versus 1.4%) between the two groups. Conclusions Low-dose aspirin therapy is not associated with progression of initial insult on RHCT or clinical deterioration. Prehospital low-dose aspirin therapy as a sole criterion should not warrant a routine repeat head CT in traumatic brain injury.

AB - Background Most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate the utility of repeat head computed tomography (RHCT) and outcomes in patients on low-dose aspirin (acetylsalicylic acid; ASA) therapy. Methods Patients with traumatic brain injury with intracranial hemorrhage on initial head computed tomography (CT) were prospectively enrolled. Patients on prehospital low-dose (81 mg) aspirin therapy were matched with patients exclusive of antiplatelet and anticoagulation therapy using propensity score matching in a 1:1 ratio for age, Glasgow Coma Scale, head Abbreviated Injury Scale score, Injury Severity Score, and neurological examination. Outcome measures were progression on RHCT and subsequent neurosurgical intervention. Results A total of 144 patients who had intracranial hemorrhage on initial CT scan (ASA group: 72; No-ASA group: 72) were enrolled. The mean age was 72.8 ± 11.7 years, 59.7% were male, and median head Abbreviated Injury Scale was 3 (2-3). There was no difference in progression on RHCT (25% in ASA versus 16.6% in no-ASA), change in management as a result of RHCT (1.4% versus 1.4%), RHCT as a result of neurological decline (0 versus 1.4%), discharge Glasgow Coma Scale (15 [14-15] versus 15 [14-15]), and mortality (0 versus 1.4%) between the two groups. Conclusions Low-dose aspirin therapy is not associated with progression of initial insult on RHCT or clinical deterioration. Prehospital low-dose aspirin therapy as a sole criterion should not warrant a routine repeat head CT in traumatic brain injury.

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