Surgeons Discover That Common Anti-Clotting Drug May Cause Problems for Some Trauma Patients
National Trauma Databank researchers find elderly patients more vulnerable to problems
CHICAGO, Oct. 15 /PRNewswire-USNewswire/ -- A common drug used
for preventing heart attacks and blood clots may also cause
problems for individuals who suffer some form of trauma,
particularly elderly patients, according to a study presented today
at the 2009 Clinical Congress of the American College of
The study findings could have implications for how doctors
prescribe warfarin as use of this drug continues to grow. Warfarin
is a blood-thinning drug that prevents clotting. Approximately 31
million prescriptions for warfarin were written in 2004, according
to the Food and Drug Administration.
Researchers from Vanderbilt University, Nashville, TN, and the
University of Texas Health Sciences Center, Houston, conducted the
first large-scale analysis of warfarin using the National Trauma
Databank (NTDB) of the American College of Surgeons. The
researchers found that warfarin use among patients 65 and older
grew from 7.3 percent in 2002 to almost 13 percent in 2006. The
study involved 1.2 million patients from 402 centers that report
data to the NTDB.
The researchers concluded that warfarin use was associated with
a 30 percent increased risk of death among all trauma patients and
a 20 percent increased risk in those 65 and older. However, lead
author Lesly A. Dossett, MD, MPH, cautioned that other factors,
such as additional health problems individuals on warfarin may
have, may explain the heightened risk of death. The study did not
make a definitive connection between warfarin use and post-trauma
"Trauma is relatively rare event for elderly patients, so if
they have a good solid reason for taking warfarin, no one would
suggest that they not take it," Dr. Dossett said. "But we have seen
patients who have had blood clots in their legs on that drug
indefinitely, whereas the recommendation is that they be on that
drug three to six months."
The National Trauma Databank includes motor-vehicle collisions
and home injuries such as falls. "If you're on warfarin and fall
from standing, that might take an otherwise innocuous event and
make it something more serious, possibly life-threatening," Dr.
Dossett said. "The patient safety message is to document another
risk of long-term warfarin use and to provide physicians who are
prescribing warfarin another piece of the puzzle." The next step is
to look at ways of correcting blood-clotting issues in trauma
patients on warfarin, Dr. Dossett said.
"Trauma surgeons see many patients--especially elderly
patients--who suffer severe consequences from combining otherwise
minor trauma with anticoagulation. This paper is a call to evaluate
the risk and benefits of anticoagulation before prescribing them,"
J. Wayne Meredith, MD, FACS, Medical Director, American College of
Surgeons Trauma Programs, said, upon hearing about the study.
Bryan A. Cotton, MD, FACS, MPH (University of Texas Health
Sciences Center) and Marie R. Griffin, MD, MPH (Vanderbilt
University) were Dr. Dossett's research colleagues on this National
Trauma Databank study.
Source: American College of Surgeons
Posted: October 2009