Surgical Management of Ipsilateral Internal Carotid Artery Stenosis and Unruptured Intracranial Aneurysm: Case Review and Treatment Considerations ; E-289 Cost-minimizing thresholds and recurrence rates in surgical evacuation with adjuvant middle meningeal artery embolization versus evacuation alone ; Radiographic abnormalities and their clinical significance in patients with Parkinson disease who receive deep brain stimulation implants ; The clinical potential of radiomics to predict hematoma expansion in spontaneous intracerebral hemorrhage: a narrative review
저자, Botros D ; 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah. Gautam D ; 2School of Medicine, University of Utah. Hamrick FA ; 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah. Nguyen S ; 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah. Cortez J ; 3Health Trauma Program, University of Utah; and. Young JB ; 4Department of General Surgery, Division of Acute Care Surgery, University of Utah, Salt Lake City, Utah. Lombardo S ; 4Department of General Surgery, Division of Acute Care Surgery, University of Utah, Salt Lake City, Utah. McCrum ML ; 4Department of General Surgery, Division of Acute Care Surgery, University of Utah, Salt Lake City, Utah. Menacho ST ; 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah. Grandhi R ; 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah. ; Content Provider, MEDLINE Ultimate ; 초록, Objective: Although oral anticoagulant use has been implicated in worse outcomes for patients with a traumatic brain injury (TBI), prior studies have mostly examined the use of vitamin K antagonists (VKAs). In an era of increasing use of direct oral anticoagulants (DOACs) in lieu of VKAs, the authors compared the survival outcomes of TBI patients on different types of premorbid anticoagulation medications with those of patients not on anticoagulation. Methods: The authors retrospectively reviewed the records of 1186 adult patients who presented at a level I trauma center with an intracranial hemorrhage after blunt trauma between 2016 and 2022. Patient demographics; comorbidities; and pre-, peri-, and postinjury characteristics were compared based on premorbid anticoagulation use. Multivariable Cox proportional hazards regression modeling of mortality was performed to adjust for risk factors that met a significance threshold of p < 0.1 on bivariate analysis. Results: Of 1186 patients with a traumatic intracranial hemorrhage, 49 (4.1%) were taking DOACs and 53 (4.5%) used VKAs at the time of injury. Patients using oral anticoagulants were more likely to be older (p < 0.001), to have a higher Charlson Comorbidity Index (p < 0.001), and to present with a higher Glasgow Coma Scale (GCS) score (p < 0.001) and lower Injury Severity Score (ISS; p < 0.001) than those on no anticoagulation. Patients using VKAs were more likely to undergo reversal than patients using DOACs (53% vs 31%, p < 0.001). Cox proportional hazards regression demonstrated significantly increased hazard ratios (HRs) for VKA use (HR 2.204, p = 0.003) and DOAC use (HR 1.973, p = 0.007). Increasing age (HR 1.040, p < 0.001), ISS (HR 1.017, p = 0.01), and Marshall score (HR 1.186, p < 0.001) were associated with an increased risk of death. A higher GCS score on admission was associated with a decreased risk of death (HR 0.912, p < 0.001). Conclusions: Patients with a traumatic intracranial injury who were on oral anticoagulant therapy before injury demonstrated higher mortality rates than patients who were not on oral anticoagulation after adjusting for age, comorbid conditions, and injury presentation. ; Publication Type, Journal Article
상세정보 Contributors In Benzel's Spine Surgery Edition: Fourth Edition. 2017:vi-xviii 저자 Abbed, Khalid M. Abdullah, Kalil G. Ackerman, Paul D. Alapan, Yunus Alentado, Vincent J....
Home University of Utah Jeffrey Lee Nadel Jeffrey Lee Nadel University of Utah | UOU... Adult Neurosurgical Patient Population Article Jul 2019 Joseph R. Linzey Jeffrey Lee Nadel David...
Home University of Utah Kyril Cole Kyril Cole University of Utah | UOU MPH MBA kyril.cole... Traumatic Neurosurgical Injuries Article Apr 2024 Kyril Cole Matt Findlay Emma Rose Earl [...]...
Specialty chief editors william tupper couldwell The University of Utah Salt Lake City... surgery, neurosurgical interventions are increasing in number and breadth. As such, neurosurgery is...
Home University of Utah Department of Neurosurgery Gmaan Alzhrani Gmaan Alzhrani University... Surgery Neurosurgical Procedures Publications Publications (46) "Brain Biopsy Revolution...
Dr. Mark Mahan is a nationally and internationally recognized expert in both complex peripheral nerve surgery and endoscopic spine surgery. He routinely teaches throughout the globe, including instruction on techniques as well as clinical and laboratory science. Dr. Mahan has published over 100 peer-reviewed papers and numerous book chapters. His laboratory research has earned several research grants, including several from the NIH. Dr. Mahan also runs several clinical trials, including trials f...
4 Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, USA. 5 Neurosurgical Associates, LLC, Murray, Utah. 6 Department of Neurosurgery, University of Utah...
*원문 PDF 파일 및 링크정보가 존재하지 않을 경우 KISTI DDS 시스템에서 제공하는 원문복사서비스를 사용할 수 있습니다.