Eur Rev Med Pharmacol Sci:老年人创伤性脑损伤前服用VK拮抗剂或DOACs是否会影响其结局?

2022-07-22 MedSci原创 MedSci原创

创伤性脑损伤(TBI)是全世界发病和死亡的一个常见原因,老年人中常见TBI。

创伤性脑损伤(TBI)是全世界发病和死亡的一个常见原因,老年人中常见TBI。近日,发表于Eur Rev Med Pharmacol Sci的一项系统回顾旨在比较老年创伤性休克患者伤前服用VK拮抗剂或DOACs的相关发病率和死亡率风险。

研究人员按照PRISMA指南对五个数据库(Web of Science、EMBASE、CENTRAL、Scopus和MEDLINE)中的学术文献进行了系统性检索。进行了随机效应荟萃分析,比较受伤前使用VK拮抗剂或DOACs对创伤性脑损伤患者的整个重症监护室和住院时间的影响。此外,研究人员还评估了VK拮抗剂和DOACs对TBI患者的颅内出血进展、手术干预和总体死亡率的相关风险。

结果,从973项研究中共纳入11项符合条件的研究,包括4991名脑外伤患者(平均年龄77.82±6.76岁)。荟萃分析结果显示,与使用DOACs相比,使用VK-拮抗剂的手术干预(OR=1.72)和死亡率(OR=1.07)的风险并未显著升高。同样,研究人员发现,服用VK-拮抗剂的人在重症监护室(Hedge's g,0.13)和住院(g,0.26)的时间也未明显长于服用DOAC的患者。此外,研究人员还观察到接受DOAC的患者的颅内出血进展风险(OR=1.22)也并不高于接受VK-拮抗剂的患者。

综上所述,该研究提供了与创伤性脑损伤患者受伤前服用VK-拮抗剂或DOACs相关的发病率和死亡率的证据。结果显示,VK-拮抗剂和DOACs对老年创伤性脑损伤患者的总体发病率(住院和重症监护室停留时间、颅内出血和手术干预频率)和死亡率结果没有显著差异。

 

原始出处:

Y-L Liu, et al., Outcomes of elderly patients with traumatic brain injury associated with the pre-injury antithrombotic prophylaxis type - A systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2022 Jun;26(12):4380-4391. doi: 10.26355/eurrev_202206_29077.

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    2023-06-29 yb6560
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createdName=amyloid, createdTime=Mon Aug 29 14:15:57 CST 2022, time=2022-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996497, encodeId=41a8199649ed1, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Thu Jun 29 05:15:57 CST 2023, time=2023-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788492, encodeId=245c1e884929a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Sep 16 06:15:57 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908725, encodeId=a9071908e259a, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat May 20 01:15:57 CST 2023, time=2023-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279383, encodeId=6c6212e9383aa, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335405, encodeId=56dd133540529, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398372, encodeId=c1b213983e20b, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511815, encodeId=d89615118152c, content=<a href='/topic/show?id=90d75628960' target=_blank style='color:#2F92EE;'>#拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56289, encryptionId=90d75628960, topicName=拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=474c10379153, createdName=ms5236388012055669, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541732, encodeId=579e1541e3289, content=<a href='/topic/show?id=1bcd61e458' target=_blank style='color:#2F92EE;'>#DOACs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6174, encryptionId=1bcd61e458, topicName=DOACs)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=589613322424, createdName=12498474m34暂无昵称, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1787815, encodeId=0a7a1e878151d, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Apr 22 07:15:57 CST 2023, time=2023-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025544, encodeId=48f32025544d3, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Mon Aug 29 14:15:57 CST 2022, time=2022-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996497, encodeId=41a8199649ed1, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Thu Jun 29 05:15:57 CST 2023, time=2023-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788492, encodeId=245c1e884929a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Sep 16 06:15:57 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908725, encodeId=a9071908e259a, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat May 20 01:15:57 CST 2023, time=2023-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279383, encodeId=6c6212e9383aa, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335405, encodeId=56dd133540529, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398372, encodeId=c1b213983e20b, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511815, encodeId=d89615118152c, content=<a href='/topic/show?id=90d75628960' target=_blank style='color:#2F92EE;'>#拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56289, encryptionId=90d75628960, topicName=拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=474c10379153, createdName=ms5236388012055669, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541732, encodeId=579e1541e3289, content=<a href='/topic/show?id=1bcd61e458' target=_blank style='color:#2F92EE;'>#DOACs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6174, encryptionId=1bcd61e458, topicName=DOACs)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=589613322424, createdName=12498474m34暂无昵称, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1787815, encodeId=0a7a1e878151d, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Apr 22 07:15:57 CST 2023, time=2023-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025544, encodeId=48f32025544d3, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Mon Aug 29 14:15:57 CST 2022, time=2022-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996497, encodeId=41a8199649ed1, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Thu Jun 29 05:15:57 CST 2023, time=2023-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788492, encodeId=245c1e884929a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Sep 16 06:15:57 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908725, encodeId=a9071908e259a, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat May 20 01:15:57 CST 2023, time=2023-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279383, encodeId=6c6212e9383aa, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335405, encodeId=56dd133540529, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa5a2500103, createdName=ms920641618706883, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398372, encodeId=c1b213983e20b, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511815, encodeId=d89615118152c, content=<a href='/topic/show?id=90d75628960' target=_blank style='color:#2F92EE;'>#拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56289, encryptionId=90d75628960, topicName=拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=474c10379153, createdName=ms5236388012055669, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541732, encodeId=579e1541e3289, content=<a href='/topic/show?id=1bcd61e458' target=_blank style='color:#2F92EE;'>#DOACs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6174, encryptionId=1bcd61e458, topicName=DOACs)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=589613322424, createdName=12498474m34暂无昵称, createdTime=Sat Jul 23 02:15:57 CST 2022, time=2022-07-23, status=1, ipAttribution=)]
    2022-07-23 yaanren
  7. [GetPortalCommentsPageByObjectIdResponse(id=1787815, encodeId=0a7a1e878151d, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Apr 22 07:15:57 CST 2023, time=2023-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025544, encodeId=48f32025544d3, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, 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  8. 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  9. 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Neuromodulation:一项前瞻性、多中心研究,评估经舌神经刺激加物理疗法治疗轻度至中度创伤性脑损伤引起的慢性平衡缺陷的安全性和有效性

创伤性脑损伤 (TBI) 的严重程度在临床上分为轻度、中度或重度,传统上基于急性意识改变的临床测量和影像学发现。本研究使用了国防部/退伍军人管理局对 TBI 严重程度的定义。轻度至中度 TBI (mm

Neurology:运动性脑震荡相关非侵入性生物标志物的蛋白质组学发现

尿IGF-1和Igfbp5与单任务步态速度相结合可能有助于运动相关脑震荡的诊断。

JNNP:创伤性脑损伤后残疾与报告健康生活质量之间的差异

中度和重度创伤性脑损伤(TBI)后残疾很常见,并且越来越多地被认为是轻度TBI的后果。在TBI之后,个人经常会在生活的不同方面遇到障碍,包括身体、社会和认知方面的限制,这可能会影响他们的福祉。健康的人

Neurology:血浆 p-tau181和 p-tau217在有或没有阿兹海默病病理证据的创伤性脑病综合征患者中的表达

血浆P-tau181和P-tau217可能是鉴定创伤性脑病综合征(TES)中AD病理的一种可行的生物标志物。较低的血浆P-Tau水平可用于增加临床怀疑CTE而不是AD作为TES的主要病理改变。

JAMA Neurol-认知行为疗法,可有效治疗创伤后应激

CBT治疗头痛对退伍军人创伤后头痛相关的残疾有疗效