2.50
Hdl Handle:
http://hdl.handle.net/10755/344126
Category:
Abstract
Type:
Poster
Title:
Do Trauma Patients Need an Aspirin?
Author(s):
Broughton-Miller, Kimberly; Wojcik, Jodi; Penetecost, Karina; Frisbie, Michelle
Lead Author STTI Affiliation:
Non-member
Author Details:
Kimberly Broughton-Miller, MSN, APRN, FNP-C, kimbbro@ulh.org; Jodi Wojcik, MSN, APRN, ANP-C; Karina Pentecost, MSN, APRN, ACNP-BC; Michelle Frisbie, MSN, APRN, ANP-C
Abstract:
Research Abstract Purpose: The purpose of this study was to assess whether trauma may be an independent risk factor for stroke.It is well described in the literature that these patient are disproportionally at risk for venous thromboembolic events, such as deep venous thrombosis and pulmonary embolism. Emerging literature focuses on better identifying at -risk patients, as well as screening and treatment of these patients. What role the prothrombotic state plays in causing acute cerebrovascular accidents in the trauma population is poorly defined. Design: A case controlled, retrospective analysis of all trauma admissions from 2008-2010 was performed. Setting: An urban academic medical center with the regional Level 1 trauma center. Participants/Subjects: A case controlled, retrospective analysis of all trauma admissions from 2008-2010 was performed. A total of 7633 patients were reviewed with 64 patients identified having suffered a cerebrovascular/accident. A control group of 120 patients matched for injury severity score(ISS) and mechanism of action (MOA) was used for comparison. Known modifiable risk factors such as history of hypertension, atrial fibrillation, diabetes, and tobacco use was assessed. Nonmodifiable risk ~factors included age, mechanism of injury, presence of associated injuries, presence of vascular injury, and presence of patentforamen ovale or other cardiac defect. A second control group of 14,121 medical and surgical patients was also obtained from the hospital database over the same time period. This group was controlled for known risk factors for CVA (age, HTN, OM, atrial fibrillation, and tobacco use. Methods: Univariate and multivariate analysis was performed on these populations. Results/Outcomes: There were 64 total strokes after admission for trauma identified in the patient population studied with the overall rate of CVA 0.8%. Out of this group, 23 injury related CVA were found, leaving 41 patients with non-injury related CVA. Compared to a control group of 120 patients matched for ISS and MOA, several significant differences were found. The 41 patients with trauma related CVA were older (age 51±24 vs 32±26, p~O.OOl). Chronic medical illnesses were more common in the trauma related CVA group as well. A pre-existing diagnosis of hypertension in the trauma related CVA group occurred in 21(51%), compared to 27{23%), p~0.002, in the control group. Diabetes was also more common in the trauma related group, 11(27%) versus 11(9%), psO.007. Tobacco abuse was more common in the eVA group (58% vs 37%, psO.02), and mortality was higher as well (22% vs 7%, pSO.009). No difference was found in presence of atrial fibrillation (7% vs 2%, p
Keywords:
Trauma and Stroke
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleDo Trauma Patients Need an Aspirin?en_GB
dc.contributor.authorBroughton-Miller, Kimberlyen_GB
dc.contributor.authorWojcik, Jodien_GB
dc.contributor.authorPenetecost, Karinaen_GB
dc.contributor.authorFrisbie, Michelleen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsKimberly Broughton-Miller, MSN, APRN, FNP-C, kimbbro@ulh.org; Jodi Wojcik, MSN, APRN, ANP-C; Karina Pentecost, MSN, APRN, ACNP-BC; Michelle Frisbie, MSN, APRN, ANP-Cen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344126-
dc.description.abstractResearch Abstract Purpose: The purpose of this study was to assess whether trauma may be an independent risk factor for stroke.It is well described in the literature that these patient are disproportionally at risk for venous thromboembolic events, such as deep venous thrombosis and pulmonary embolism. Emerging literature focuses on better identifying at -risk patients, as well as screening and treatment of these patients. What role the prothrombotic state plays in causing acute cerebrovascular accidents in the trauma population is poorly defined. Design: A case controlled, retrospective analysis of all trauma admissions from 2008-2010 was performed. Setting: An urban academic medical center with the regional Level 1 trauma center. Participants/Subjects: A case controlled, retrospective analysis of all trauma admissions from 2008-2010 was performed. A total of 7633 patients were reviewed with 64 patients identified having suffered a cerebrovascular/accident. A control group of 120 patients matched for injury severity score(ISS) and mechanism of action (MOA) was used for comparison. Known modifiable risk factors such as history of hypertension, atrial fibrillation, diabetes, and tobacco use was assessed. Nonmodifiable risk ~factors included age, mechanism of injury, presence of associated injuries, presence of vascular injury, and presence of patentforamen ovale or other cardiac defect. A second control group of 14,121 medical and surgical patients was also obtained from the hospital database over the same time period. This group was controlled for known risk factors for CVA (age, HTN, OM, atrial fibrillation, and tobacco use. Methods: Univariate and multivariate analysis was performed on these populations. Results/Outcomes: There were 64 total strokes after admission for trauma identified in the patient population studied with the overall rate of CVA 0.8%. Out of this group, 23 injury related CVA were found, leaving 41 patients with non-injury related CVA. Compared to a control group of 120 patients matched for ISS and MOA, several significant differences were found. The 41 patients with trauma related CVA were older (age 51±24 vs 32±26, p~O.OOl). Chronic medical illnesses were more common in the trauma related CVA group as well. A pre-existing diagnosis of hypertension in the trauma related CVA group occurred in 21(51%), compared to 27{23%), p~0.002, in the control group. Diabetes was also more common in the trauma related group, 11(27%) versus 11(9%), psO.007. Tobacco abuse was more common in the eVA group (58% vs 37%, psO.02), and mortality was higher as well (22% vs 7%, pSO.009). No difference was found in presence of atrial fibrillation (7% vs 2%, p<O.l). A higher rate of extended care facility placement was required in the trauma related eVA group, as well (81% vs 28%, pSO.OOO1). / database over the same time period, trauma patients were 1.6 times more likely to develop eVA during , admission (p=O.024). Furthermore, on logistical regression, trauma was the only significant risk factor for eVA between the two groups. The trauma related patients ended to be younger and, on follow-up, had higher 6 month post CVA functional assessment compared to med/surg patients. Implications: Better and more widespread screening methods for coagulation abnormalities should be considered including thromboelastography in determining hypercoagulabilety after trauma. Better risk stratification of patients with known risk factors and reevaluation of the efficacy of current antithrombotic regimens are necessary.en_GB
dc.subjectTrauma and Strokeen_GB
dc.date.available2015-02-04T11:26:57Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:26:57Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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