Background and objectives: In patients who receive antiplatelet therapy (APT), the bleeding risk profile after mild head trauma (MHT) still needs clarification. Some studies have demonstrated an association with bleeding risk, whereas others have not. We studied the population of our level II emergency department (ED) trauma center to determine the risk of bleeding in patients receiving APT and whether bleeding results not from antiplatelet agents but rather from age. We assessed the bleeding risk, the incidence of intracranial hemorrhage (ICH) that necessitated hospitalization for observation, the need for cranial neurosurgery, the severity of the patient’s condition at discharge, and the frequency of ED revisits for head trauma in patients receiving APT. Materials and Methods: This retrospective single-center study included 483 patients receiving APT who were in the ED for MHT in 2019. The control group consisted of 1443 patients in the ED with MHT over the same period who were not receiving APT or anticoagulant therapy. Our ED diagnostic therapeutic protocol mandates both triage and the medical examination to identify patients with MHT who are taking any anticoagulant or APT. Results: APT was not significantly associated with bleeding risk (p > 0.05); as a risk factor, age was significantly associated with the risk of bleeding, even after adjustment for therapy. Patients receiving APT had a greater need of surgery (1.2% vs. 0.4%; p < 0.0001) and a higher rate of hospitalization (52.9% vs. 37.4%; p < 0.0001), and their clinical condition was more severe (evaluated according to the exit code value on a one-dimensional quantitative five-point numerical scale) at the time of discharge (p = 0.013). The frequency of ED revisits due to head trauma did not differ between the two groups. Conclusions: The risk of bleeding in patients receiving APT who had MHT was no higher than that in the control group. However, the clinical condition of patients receiving APT, including hospital admission for ICH monitoring and cranial neurosurgical interventions, was more severe.

中文翻译：

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轻度头部创伤：抗血小板治疗是出血并发症的危险因素吗？


背景和目标：在接受抗血小板治疗（APT）的患者中，轻度头部创伤（MHT）后的出血风险状况仍需要澄清。一些研究已证明与出血风险相关，而另一些研究则没有。我们对二级急诊 (ED) 创伤中心的人群进行了研究，以确定接受 APT 的患者的出血风险，以及出血是否不是由抗血小板药物引起，而是由年龄引起。我们评估了接受 APT 的患者的出血风险、需要住院观察的颅内出血 (ICH) 发生率、颅神经外科手术的需要、患者出院时病情的严重程度以及因头部外伤而急诊科复诊的频率。材料和方法：这项回顾性单中心研究纳入了 483 名 2019 年在急诊室接受 MHT 治疗的患者。对照组包括 1443 名同期在急诊室接受 MHT 治疗但未接受 APT 或抗凝治疗的患者。我们的 ED 诊断治疗方案要求进行分诊和体检，以识别正在服用任何抗凝剂或 APT 的 MHT 患者。结果：APT 与出血风险没有显着相关性 ( p > 0.05)；作为一个危险因素，年龄与出血风险显着相关，即使在调整治疗后也是如此。接受 APT 的患者手术需求更大（1.2% vs. 0.4%； p < 0.0001），住院率也更高（52.9% vs. 37.4%； p < 0.0001），出院时临床状况更严重（根据一维定量五点数值表上的退出代码值进行评估）（ p = 0.013）。两组之间因头部外伤而再次就诊急诊室的频率没有差异。结论：合并MHT且接受APT的患者出血风险不高于对照组。然而，接受APT的患者的临床状况（包括入院进行ICH监测和颅神经外科干预）更为严重。