Hemorrhage After Minor Head Injury in Patients on Direct Oral Anticoagulants

Rates of immediate hemorrhage were lower with direct oral anticoagulants than with vitamin K antagonists and rates of delayed bleeds were similar.

Anticoagulated patients are at risk for intracranial hemorrhage after minor head injury. The risk for delayed bleeds after an initially negative head computed tomography (CT) scan is well described for patients taking vitamin K antagonists (VKAs) but less clear for those on direct oral anticoagulants (DOACs).

To compare risk for immediate and delayed hemorrhage in patients with minor head injury (Glasgow Coma Scale score, 13–15) taking DOACs versus VKAs, researchers in Italy performed a chart review. By protocol, all such patients received an immediate head CT scan, were observed for 24 hours, and then received another CT scan. Exclusions included incomplete data, VKA treatment with international normalized ratio <1.5, and DOAC treatment wit…

Reviewing Author

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Hemorrhage After Minor Head Injury in Patients on Direct Oral Anticoagulants

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Reviewing Author