Monotherapy Aspirin in Minor Traumatic Head Bleeds does not Worsen Outcome

Abstract

Abstract INTRODUCTION Traumatic head bleeds (THBs) are one of the most common neurosurgical consults in the trauma/acute care setting. U.S. adults on monotherapy aspirin (mASA) are presumed to have increased risk for Worsened outcomes after THBs. It is crucial to understand the effect mASA has on THBs. METHODS A retrospective review of prospectively collected data on THBs at a single center from 2013 to 2018 collected age, BIG category, aspirin use and dose, Injury Severity Score (ISS), length of stay (LOS), and days in intensive care unit (ICU days). Please refer to the Brain Injury Guideline protocol as defined by the University of Arizona study. All patients were categorized according to their imaging alone. For example, a patient on mASA with an initial CT head of BIG 1 category is coded as “BIG 1a,” as opposed to “BIG 3,” per BIG brain injury guidelines. RESULTS A total of 630 patients (mean age 71.5 yr) were included. MASA use in BIG-1 and BIG-2 graded THBs did not increase LOS (P = .79; P = .159) and ICU days (P = .74; P = .089) when compared to non-aspirin counterparts. MASA use in BIG-1 and BIG-2 THBs has significantly shorter LOS (P < .0001; P < .0001) and fewer ICU days (P < .0001; P < .0001) when compared to BIG-3 counterparts. MASA use in BIG-1 and BIG-2 THBs resulted in lower ISS as compared to BIG-3 THBs (P < .0001; P < .0001). BIG-3 THBs on mASA had decreased ISS when compared to non-aspirin counterparts (P = .0001). There was no difference between BIG-2 THBs with or without mASA use (P = .353). CONCLUSION There is no significant increase in ISS, LOS, or ICU days in patients on mASA with THBs. Patients on mASA therapy behave similar hospital stays as compared to non-aspirin counterparts, requiring shorter hospitalization/ICU days.