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Epidemiology and outcomes of missing admission medication history in severe trauma: A retrospective study
Author(s) -
Miller Matthew,
Morris Richard,
Fisicaro Nicoletta,
Curtis Kate
Publication year - 2017
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12817
Subject(s) - medicine , retrospective cohort study , epidemiology , adverse effect , emergency medicine , pediatrics
Objective Anticoagulant and antiplatelet ( ACAP ) drugs are associated with increased mortality in trauma patients, therefore medication history on admission is important. Whether these medications are recorded on trauma admission has not been investigated, nor if absence of a medication history is associated with worse patient outcomes. Methods We conducted a retrospective database review combining demographic and outcome data from the St George Hospital (Sydney) trauma registry with admission medication history in the electronic record. To contrast medications with a known increased risk ( ACAP ) to patients with unknown risk, patients were divided into three groups: those on ACAPs , no‐ ACAP if medication history was present and no‐ ACAP documented, or no‐Hx if no medication history recorded. Inclusion criteria were aged >16 and Injury Severity Score ( ISS ) >12. Admission demographic data and outcome data were compared between all three groups. Results Of 533 consecutive patients, 21% comprised the no‐Hx group, while 22% were on an ACAP and 57% not on an ACAP . No‐Hx patients had more severe head injuries and a younger median age compared to ACAP patients (42 vs 82 years old, P < 0.001). Mortality was higher for ACAP (24%; 95% CI 17–33%) compared to no‐ ACAP (11%; 95% CI 8–16%) or no‐Hx patients (12%; 95% CI 7–20%) ( P = 0.04). Conclusions While a large number of severe trauma patients were admitted without a medication history, no‐Hx patients did not appear at increased risk of adverse outcomes. ACAP patients had a higher mortality compared to no‐ ACAP highlighting the vulnerability of this group.