Abstract
The correlation between direct oral anticoagulants (DOACs) or Vitamin K Antagonist
(VKAs) intake and the incidence of intracranial complications after minor head injury
(MHI) is still object of debate: preliminary observation seems to demonstrate lower
incidence in intracranial bleeding complications (ICH) in patients taking DOACs than
VKA. METHODS. This prospective and observational study was performed to clarify the
incidence of ICH in patients in DOACs compared to VKAs. Between January 2016 and April
2018 we have recorded in our ED patients with MHI taking oral anticoagulants. Their
hemorragic risk score was calculated and recorded for each patient (Has Bled, Atria
and Orbit). RESULTS A total of 402 patients with MHI taking anticoagulant were collected:
226 were receiving one of the four DOACs (dabigatran, rivaroxaban, apixaban or edoxaban)
while 176 patients were in therapy with VKA. The rate of intracranial complications
was significantly lower in patients receiving DOACs than in patients treated with
VKA (p < 0.01). In the VKA group two patients died because of intracranial bleeding. No
deaths were recorded in the DOACs group. DISCUSSION patients with MHI who take DOACs
have a significant lower incidence of intracranial bleeding complications than those
treated with vitamin k antagonists. This statement is supported by the observation
that the hemorrhagic risk, measured according to the chosen scores, was similar between
the two groups.
Keywords
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Article Info
Publication History
Published online: December 03, 2018
Accepted:
December 3,
2018
Received in revised form:
November 29,
2018
Received:
July 16,
2018
Footnotes
☆This study was authorized by the medical direction of our hospital and patients were informed and signed their consent to their data collection.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
