Abstract：
UNASSIGNED: With the increasing cases of TBI cases in the elderly population taking anticoagulants for comorbidities, there is a need to better understand the safety of new anticoagulants and how to manage anticoagulated TBI patients.
UNASSIGNED: A meta-analysis using a random-effect model was conducted to compare the effect of preinjury use of DOACs and VKAs on the outcomes following TBI.
UNASSIGNED: From 1951 studies, 49 studies with a total sample size of 15,180 met our inclusion criteria. Our meta-analysis showed no difference between preinjury use of DOACs or VKAs on ICH progression, in-hospital delayed ICH, delayed ICH at follow-up, and in-hospital mortality, but using DOACs was associated with a lower risk of immediate ICH (OR = 0.58; 95% CI = [0.42; 0.79]; p < 0.01) and neurosurgical interventions (OR = 0.59; 95% CI = [0.42; 0.82]; p < 0.01) compared to VKAs. Moreover, patients on DOACs experienced shorter length of stay in the hospital than those on VKAs (OR = -0.42; 95% CI = [-0.78; -0.07]; p = 0.02).
UNASSIGNED: We found a lower risk of immediate ICH and surgical interventions as well as a shorter hospital stay in patients receiving DOACs compared to VKA users before the head injury.
UNASSIGNED: A meta-analysis using a random-effect model was conducted to compare the effect of preinjury use of DOACs and VKAs on the outcomes following TBI.
UNASSIGNED: From 1951 studies, 49 studies with a total sample size of 15,180 met our inclusion criteria. Our meta-analysis showed no difference between preinjury use of DOACs or VKAs on ICH progression, in-hospital delayed ICH, delayed ICH at follow-up, and in-hospital mortality, but using DOACs was associated with a lower risk of immediate ICH (OR = 0.58; 95% CI = [0.42; 0.79]; p < 0.01) and neurosurgical interventions (OR = 0.59; 95% CI = [0.42; 0.82]; p < 0.01) compared to VKAs. Moreover, patients on DOACs experienced shorter length of stay in the hospital than those on VKAs (OR = -0.42; 95% CI = [-0.78; -0.07]; p = 0.02).
UNASSIGNED: We found a lower risk of immediate ICH and surgical interventions as well as a shorter hospital stay in patients receiving DOACs compared to VKA users before the head injury.
摘要：
■随着老年人群因合并症服用抗凝药的TBI病例的增加，有必要更好地了解新型抗凝剂的安全性以及如何管理抗凝TBI患者.
■使用随机效应模型进行了荟萃分析，以比较损伤前使用DOAC和VKAs对TBI后结局的影响。
■来自1951年的研究，49项研究，总样本量为15,180项，符合我们的纳入标准。我们的荟萃分析显示，损伤前使用DOAC或VKAs对ICH进展没有差异，住院延迟ICH，随访时延迟ICH，和住院死亡率，但与VKAs相比,使用DOAC与即刻ICH(OR=0.58;95%CI=[0.42;0.79];p<0.01)和神经外科干预(OR=0.59;95%CI=[0.42;0.82];p<0.01)的风险较低相关.此外，DOAC组患者的住院时间短于VKAs组(OR=-0.42;95%CI=[-0.78;-0.07];p=0.02).
我们发现，与头部受伤前的VKA使用者相比，接受DOAC的患者立即发生ICH和手术干预的风险较低，住院时间较短。
■使用随机效应模型进行了荟萃分析，以比较损伤前使用DOAC和VKAs对TBI后结局的影响。
■来自1951年的研究，49项研究，总样本量为15,180项，符合我们的纳入标准。我们的荟萃分析显示，损伤前使用DOAC或VKAs对ICH进展没有差异，住院延迟ICH，随访时延迟ICH，和住院死亡率，但与VKAs相比,使用DOAC与即刻ICH(OR=0.58;95%CI=[0.42;0.79];p<0.01)和神经外科干预(OR=0.59;95%CI=[0.42;0.82];p<0.01)的风险较低相关.此外，DOAC组患者的住院时间短于VKAs组(OR=-0.42;95%CI=[-0.78;-0.07];p=0.02).
我们发现，与头部受伤前的VKA使用者相比，接受DOAC的患者立即发生ICH和手术干预的风险较低，住院时间较短。
