Should Head CT Be Automatic for Head Trauma Patients on Anticoagulants or Antiplatelets?

Anticoagulant and antiplatelet agents are thought to increase the risk for intracranial hemorrhage after trauma, but this is based mostly on retrospective data. To compare rates of important intracranial injury in patients with blunt head injury who were and were not taking these medications, researchers performed a secondary analysis of a prospective observational study. Adults undergoing head computed tomography (CT) imaging at the treating emergency physicians' discretion at three emergency departments from 2007 to 2015 were eligible. Patients presenting >24 hours after injury or with already-known intracranial injuries were excluded.

Of 9070 patients enrolled, 39% were women, and median age was 54. Among the 5715 patients not on anticoag…