Abstract
BackgroundAnticoagulant and antiplatelet agents (ACAP) have been shown to negatively affect trauma patients. MethodsOutcomes in adults with rib fractures were reviewed. Pearson chi-square test was used for analysis. Multivariate logistic regression was used to adjust for potential confounders. ResultsOf the 1448 included patients, 149 (10.3%) took preinjury ACAP; these patients were significantly older than non-anticoagulated patients (72 vs. 54 years, P ≤ 0.05). There was no difference in pulmonary complications, ICU admissions or ICU LOS. The preinjury ACAP group had a significantly longer LOS (12.03 vs. 9.33 days, P = 0.004), fewer pulmonary contusions (15.43% vs. 22.94%, P = 0.037), and fewer thoracic drainage procedures (10.74% vs. 18.17%, P = 0.023). Multivariate adjustment for possible confounders revealed that patients taking warfarin had a significantly longer LOS (+7.38 days). After adjustment there was no difference in mortality. ConclusionPreinjury ACAP use does not increase mortality or morbidity in patients with rib fractures. SummaryWe demonstrated that preinjury anticoagulation and antiplatelet agents do not increase mortality or morbidity in patients with rib fractures. However, they lead to a longer hospital length of stay, particularly in patients on warfarin.
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