The effects of preinjury clopidogrel use on older trauma patients with head injuries

Background This study was designed to determine whether or not older trauma patients on clopidogrel have an increased risk of morbidity and mortality. Methods A retrospective review was performed on all trauma patients ≥50 years of age between January 1, 2002, and August 31, 2005. The charts of those patients who had documented preinjury use of clopidogrel were further reviewed. A control group of patients with no history of clopidogrel use was matched for age, sex, mechanism of injury, and injury severity score. Results During this time period, there were 1,020 trauma patients ≥50 years of age admitted, 43 of which had documented preinjury clopidogrel use (P). A higher percentage of patients in the P group underwent cranial surgery, had episodes of rebleeds, and required transfusions of blood products than in the control group. The mortality and length of stay were comparable in both groups. Conclusion This study indicates that the preinjury use of clopidogrel may cause significant morbidity in patients with closed-head injuries. Further studies are needed to suggest specific treatment modalities.