• James M Feeney, Matthew Neulander, Monica DiFiori, Lilla Kis, David S Shapiro, Vijay Jayaraman, William T Marshall, and Stephanie C Montgomery.
• Saint Francis Hospital and Medical Center, Department of Surgery, 114 Woodland St. Hartford, CT 06103, USA; University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030, USA. Electronic address: feeneymd@yahoo.com.
• Injury. 2017 Jan 1; 48 (1): 47-50.

MethodsWe queried our Trauma Quality Improvement Program registry for patients who presented between 6/1/2011 and 9/1/2015 with severe (injury severity score (ISS)>15) blunt traumatic injury during anticoagulant use. Patients were then grouped into those prescribed warfarin and patients prescribed any of the available novel Direct Oral Anticoagulants (DOAC) medications. We excluded severe (AIS≧4) head injuries.ResultsThere were no differences between DOAC and warfarin groups in terms of age, gender mean ISS, median hospital or intensive care unit lengths of stay, complication proportions, numbers of complications per patient, or the proportion of patients requiring transfusion. Finally, excluding patients who died, the observed proportion of discharge to skilled nursing facility was similar. In our sample of trauma patients, DOAC use was associated with significantly lower mortality (DOAC group 8.3% vs. warfarin group 29.5%, p<0.015). The ratio of units transfused per patient was also lower in the DOAC group (2.8±1.8 units/patient in the DOAC group vs. 6.7±6.4 units per patient in the warfarin group; p=0.001).ConclusionIn conclusion, we report an association with decrease in mortality and a decrease in transfused blood products in severely injured trauma patients with likely minimal or no head injury taking novel DOACs over those anticoagulated with warfarin for outpatient anticoagulation.Copyright © 2016 Elsevier Ltd. All rights reserved.

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