Literature DB >> 25133148

Dabigatran etixilate and traumatic brain injury: Evolving anticoagulants require evolving care plans.

Sam Pakraftar1, Daniela Atencio1, John English1, Alain Corcos1, Eric M Altschuler1, Kurt Stahlfeld1.   

Abstract

AIM: To investigate the outcomes of trauma patients with traumatic brain injury (TBI) on Dabigatran Etexilate (DE).
METHODS: Following IRB approval, all patients taking DE who were admitted to our level 1 trauma service were enrolled in the study. Injury complexity, length of stay (LOS), intensive care length of stay, operative intervention, therapeutic interventions and outcomes were analyzed retrospectively.
RESULTS: Twenty-eight of 4310 admissions were taking DE. Eleven patients were excluded on concurrent antiplatelet therapy. Average age was 77.14 years (64-94 years), and average LOS was 4.7 d (1-35 d). Thirty-two percent were admitted with intracranial hemorrhage. Eighteen percent received factor VII, and 22% received dialysis in attempts to correct coagulopathy. Mortality was 21%.
CONCLUSION: The low incidence, absence of reversal agents, and lack of practice guidelines makes managing patients with TBI taking DE frustrating and provider specific. Local practice guidelines may be helpful in managing such patients.

Entities:  

Keywords:  Anticoagulation; Brain injury; Dabigatran; Dabigatran reversal

Year:  2014        PMID: 25133148      PMCID: PMC4133427          DOI: 10.12998/wjcc.v2.i8.362

Source DB:  PubMed          Journal:  World J Clin Cases        ISSN: 2307-8960            Impact factor:   1.337


  16 in total

1.  Recombinant factor VIIa (rFVIIa) and hemodialysis to manage massive dabigatran-associated postcardiac surgery bleeding.

Authors:  Theodore E Warkentin; Peter Margetts; Stuart J Connolly; Andre Lamy; Chris Ricci; John W Eikelboom
Journal:  Blood       Date:  2012-03-01       Impact factor: 22.113

Review 2.  Oral anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Authors:  Walter Ageno; Alexander S Gallus; Ann Wittkowsky; Mark Crowther; Elaine M Hylek; Gualtiero Palareti
Journal:  Chest       Date:  2012-02       Impact factor: 9.410

3.  New antithrombotic drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

Authors:  Jeffrey I Weitz; Jack Hirsh; Meyer M Samama
Journal:  Chest       Date:  2008-06       Impact factor: 9.410

Review 4.  Dabigatran etexilate--a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity.

Authors:  Joanne van Ryn; Joachim Stangier; Sebastian Haertter; Karl-Heinz Liesenfeld; Wolfgang Wienen; Martin Feuring; Andreas Clemens
Journal:  Thromb Haemost       Date:  2010-03-29       Impact factor: 5.249

5.  The effect of dabigatran on select specialty coagulation assays.

Authors:  Dorothy M Adcock; Robert Gosselin; Steve Kitchen; Denis M Dwyre
Journal:  Am J Clin Pathol       Date:  2013-01       Impact factor: 2.493

6.  Intracranial hemorrhage in atrial fibrillation patients during anticoagulation with warfarin or dabigatran: the RE-LY trial.

Authors:  Robert G Hart; Hans-Christoph Diener; Sean Yang; Stuart J Connolly; Lars Wallentin; Paul A Reilly; Michael D Ezekowitz; Salim Yusuf
Journal:  Stroke       Date:  2012-04-05       Impact factor: 7.914

Review 7.  Reversal of novel oral anticoagulants in patients with major bleeding.

Authors:  Deborah M Siegal; Adam Cuker
Journal:  J Thromb Thrombolysis       Date:  2013-04       Impact factor: 2.300

Review 8.  Acute management of bleeding in patients on novel oral anticoagulants.

Authors:  Deborah M Siegal; Mark A Crowther
Journal:  Eur Heart J       Date:  2012-12-07       Impact factor: 29.983

9.  Dabigatran versus warfarin in patients with atrial fibrillation.

Authors:  Stuart J Connolly; Michael D Ezekowitz; Salim Yusuf; John Eikelboom; Jonas Oldgren; Amit Parekh; Janice Pogue; Paul A Reilly; Ellison Themeles; Jeanne Varrone; Susan Wang; Marco Alings; Denis Xavier; Jun Zhu; Rafael Diaz; Basil S Lewis; Harald Darius; Hans-Christoph Diener; Campbell D Joyner; Lars Wallentin
Journal:  N Engl J Med       Date:  2009-08-30       Impact factor: 91.245

10.  Removal of dabigatran by hemodialysis.

Authors:  Don N Chang; William E Dager; Andrew I Chin
Journal:  Am J Kidney Dis       Date:  2012-12-05       Impact factor: 8.860

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  3 in total

1.  Prevalence of Intracranial Hemorrhage after Blunt Head Trauma in Patients on Pre-injury Dabigatran.

Authors:  James A Chenoweth; M Austin Johnson; Laura Shook; Mark E Sutter; Daniel K Nishijima; James F Holmes
Journal:  West J Emerg Med       Date:  2017-07-14

2.  The Reversal of Bleeding Caused by New Oral Anticoagulants (NOACs): A Systematic Review and Meta-Analysis.

Authors:  Sariya Udayachalerm; Sasivimol Rattanasiri; Teeranan Angkananard; John Attia; Nakarin Sansanayudh; Ammarin Thakkinstian
Journal:  Clin Appl Thromb Hemost       Date:  2018-09-03       Impact factor: 2.389

3.  Point-of-care detection and differentiation of anticoagulant therapy - development of thromboelastometry-guided decision-making support algorithms.

Authors:  Simon T Schäfer; Anne-Christine Otto; Alice-Christin Acevedo; Klaus Görlinger; Steffen Massberg; Tobias Kammerer; Philipp Groene
Journal:  Thromb J       Date:  2021-09-07
  3 in total

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