دورية أكاديمية
Management of Antithrombotic Drugs in Patients with Isolated Traumatic Brain Injury : An Intersociety Consensus Document
| العنوان: | Management of Antithrombotic Drugs in Patients with Isolated Traumatic Brain Injury : An Intersociety Consensus Document |
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| المؤلفون: | Iaccarino, Corrado, Carretta, Alessandro, Demetriades, Andreas K., Di Minno, Giovanni, Giussani, Carlo, Marcucci, Rossella, Marklund, Niklas, Mastrojanni, Gianmattia, Pompucci, Angelo, Stefini, Roberto, Zona, Gianluigi, Cividini, Andrea, Petrella, Gianpaolo, Coluccio, Valeria, Marietta, Marco |
| المصدر: | Neurocritical Care; (2023) ; ISSN: 1541-6933 |
| بيانات النشر: | Humana Press |
| سنة النشر: | 2023 |
| المجموعة: | Lund University Publications (LUP) |
| مصطلحات موضوعية: | Anesthesiology and Intensive Care, Anticoagulant, Antiplatelet, Consensus, DOAC, Hemorrhage progression, Reversal strategy, Thrombotic risk, Traumatic brain injury |
| الوصف: | Background: All available recommendations about the management of antithrombotic therapies (ATs) in patients who experienced traumatic brain injury (TBI) are mainly based on expert opinion because of the lack of strength in the available evidence-based medicine. Currently, the withdrawal and the resumption of AT in these patients is empirical, widely variable, and based on the individual assessment of the attending physician. The main difficulty is to balance the thrombotic and hemorrhagic risks to improve patient outcome. Methods: Under the endorsement of the Neurotraumatology Section of Italian Society of Neurosurgery, the Italian Society for the Study about Haemostasis and Thrombosis, the Italian Society of Anaesthesia, Analgesia, Resuscitation, and Intensive Care, and the European Association of Neurosurgical Societies, a working group (WG) of clinicians completed two rounds of questionnaires, using the Delphi method, in a multidisciplinary setting. A table for thrombotic and bleeding risk, with a dichotomization in high risk and low risk, was established before questionnaire administration. In this table, the risk is calculated by matching different isolated TBI (iTBI) scenarios such as acute and chronic subdural hematomas, extradural hematoma, brain contusion (intracerebral hemorrhage), and traumatic subarachnoid hemorrhage with patients under active AT treatment. The registered indication could include AT primary prevention, cardiac valve prosthesis, vascular stents, venous thromboembolism, and atrial fibrillation. Results: The WG proposed a total of 28 statements encompassing the most common clinical scenarios about the withdrawal of antiplatelets, vitamin K antagonists, and direct oral anticoagulants in patients who experienced blunt iTBI. The WG voted on the grade of appropriateness of seven recommended interventions. Overall, the panel reached an agreement for 20 of 28 (71%) questions, deeming 11 of 28 (39%) as appropriate and 9 of 28 (32%) as inappropriate interventions. The appropriateness of ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://lup.lub.lu.se/record/f80f3fdc-2968-43e7-8d5b-b9d3dac1defbTest; http://dx.doi.org/10.1007/s12028-023-01715-3Test; scopus:85151977915; pmid:37029314 |
| DOI: | 10.1007/s12028-023-01715-3 |
| الإتاحة: | https://doi.org/10.1007/s12028-023-01715-3Test https://lup.lub.lu.se/record/f80f3fdc-2968-43e7-8d5b-b9d3dac1defbTest |
| رقم الانضمام: | edsbas.25040A2B |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s12028-023-01715-3 |
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