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Retrospective observational study on a cohort of 2 years to evaluate the incidence of brain hemorrhage present at control head CT scan executed after routine 24h observation period of ED stay in patients with minor head injury on anticoagulant therapy or DAPT with an initial negative head CT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Traumatic brain injury ANTICOAGULANT | TBI with anticoagulant treatment | ||
| Traumatic brain injury DUALANTIPLATELET | TBI with dual-antiplatelet treatment |
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| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the incidence of brain hemorrhage present at control head CT scan executed after routine 24h observation period of ED stay in patients with minor head injury on anticoagulant therapy or DAPT with an initial negative head CT. | To evaluate the incidence of brain hemorrhage present at control head CT scan executed after routine 24h observation period of ED stay in patients with minor head injury on anticoagulant therapy or DAPT with an initial negative head CT. | From enrollment to the end of ED observation at 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| To determine the incidence of a major brain hemorrhage (requiring neurosurgical intervention) or hospital admission at repeat (24h) head CT scan in patients with an initial negative CT. | To determine the incidence of a major brain hemorrhage (requiring neurosurgical intervention) or hospital admission at repeat (24h) head CT scan in patients with an initial negative CT. | From enrollment to the end of ED observation at 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients admitted to the ER with minor traumatic head injury
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| U.O. Pronto Soccorso - DEA II Livello IRCCS Ospedale San Raffaele Via Olgettina 60, 20132, Milano | Milan | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | 1. National Institute for Health and Care Excellence. Head Injury: assessment and management - Evidence review for admission and observation in hospital of people with head injury who are on anticoagulant or antiplatelet therapy after normal brain imaging or no indication for early imaging NICE guideline NG232. 2023. 2. Valente JH, Anderson JD, Paolo WF, Sarmiento K, omaszewski CA, Haukoos JS, et al. Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Mild Traumatic Brain Injury: pproved by ACEP Board of Directors, February 1, 2023 Clinical Policy Endorsed by the Emergency Nurses Association (April 5, 2023). Vol. 81, Annals of Emergency Medicine. Elsevier Inc.; 023. pag. e63-105. 3. Haydel M. Management of mild traumatic brain injury in the emergency department. Emerg Med Pract. 2025 Feb 15;27(Suppl 2):1-46. PMID: 39903864. 4. Hadwe S El, Assamadi M, Barrit S, Giannis D, Haidich AB, Goulis DG, et al. Delayed intracranial hemorrhage of patients with mild traumatic brain injury under antithrombotics on routine repeat CT scan: a systematic review and meta-analysis. Vol. 36, Brain Injury. 2022 5. Ethridge M, Keller J, Edhayan E. Risk of delayed intracranial hemorrhage in patients on anticoagulation with negative initial imaging. Am J Surg. 2021 Mar;221(3):606-608. doi: 10.1016/j.amjsurg.2021.01.011. Epub 2021 Jan 16. PMID: 33485622. |
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| ID | Term |
|---|---|
| D020300 | Intracranial Hemorrhages |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |