What question did this study set out to answer?

This research aims to evaluate the association between preinjury antithrombotic medication and outcomes in older trauma patients aged 65 and above.

February 25, 2026Open Access

Short-term impact of preinjury antithrombotic therapy on outcomes in older trauma patients

Key Points

This research aims to evaluate the association between preinjury antithrombotic medication and outcomes in older trauma patients aged 65 and above.
Data collected from trauma patients aged ≥ 65 in the West-Netherlands trauma region.
Preinjury antithrombotic medication was documented in trauma registry records.
Patient outcomes were defined by in-hospital mortality and Glasgow Outcome Scale score at discharge.
Multivariable logistic regression was used to analyze associations.
50% of patients used antithrombotic medication, predominantly platelet aggregation inhibitors and direct oral anticoagulants.
PAM users were older, predominantly male, and had more comorbidities.
No significant association found between PAM and increased injury severity score or intracranial hemorrhages.
Adjusted odds ratio for mortality was 0.79, suggesting no increased risk, and GOS scores showed no significant difference.

Abstract

Preinjury use of antithrombotic medication (PAM) may increase bleeding risk and adverse outcomes in older trauma patients. PAM is not routinely recorded in the Dutch trauma registry, leaving its impact on outcomes unclear. This study describes PAM among older trauma patients and assesses its association with injury patterns and patient outcomes, thereby informing whether routine documentation in trauma registries would be useful. Data from trauma patients aged ≥ 65 years admitted to hospitals within the West-Netherlands trauma region in June-September 2024 were obtained from the regional trauma registry. PAM was additionally documented during this period. Poor outcome was defined as in-hospital mortality and Glasgow Outcome Scale (GOS) score ≤ 3 at hospital discharge. Associations between PAM and outcomes were analyzed using multivariable logistic regression. Of 1,112 patients, 50% used antithrombotic medication, most commonly platelet aggregation inhibitors (47%) or direct oral anticoagulants (37%). Users were older, more often male, had more comorbidities, and more frequently sustained low-energy falls and minor head injuries. PAM was not associated with higher ISS (median 9 in both groups, p = 0.80), more intracranial hemorrhages (74% vs. 71%, p = 0.85), increased mortality (adjusted odds ratio OR, 0.79; 95% Confidence Interval CI, 0.41–1.53), or poor GOS at discharge (OR, 1.06; 95% CI, 0.79–1.43). PAM is common among older trauma patients. In this exploratory study, PAM did not seem to be associated with more severe injuries or poorer short-term outcomes. To evaluate the in-depth and long-term effects structured documentation of PAM in trauma registries is advocated.

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