Aspirin does not increase the need for haemostatic interventions in blunt liver and spleen injuries. Issue 9 (September 2021)

• Record Type: Journal Article
• Authors: Huang, Jen-Fu; Cheng, Chi-Tung; Fu, Chih-Yuan; Huang, Yu-Tung Anton; Hsu, Chih-Po; OuYang, Chun-Hsiang; Liao, Chien-Hung; Hsieh, Chi-Hsun; Chang, Shang-Hung
• Is Part Of: Injury. Volume 52:Issue 9(2021)
• Page Start: 2594
• Page End: 2600
• Publication Date: 2021-09
• Subjects: Hepatic injury -- Splenic injury -- Aspirin -- Transarterial angioembolization -- Surgery; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2021.05.025
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: The prohemorrhagic effect of aspirin may cause concern about worse prognoses when treating blunt hepatic or splenic injuries. Preinjury aspirin use was not associated with increased hemostatic procedures in blunt hepatic or splenic injuries. The associated multiple organ injury and severity of trauma were the major determinants for interventions. Abstract: Purpose: The prohemorrhagic effect of aspirin may cause concern about worse prognoses when treating blunt hepatic or splenic injuries. This study investigated whether preinjury aspirin yields an increasing need for haemostatic interventions. Methods: Admission and outpatient records were extracted from the Taiwan National Health Insurance Research Database (NHIRD) from 2003 to 2015. Patients with splenic or hepatic injuries were identified, and those with preinjury nonaspirin APAC or with penetrating injuries were excluded. The primary outcome measurement was the necessity of invasive procedures to stop bleeding, including transarterial embolization (TAE) and surgeries. One-to-two propensity score matching (PSM) was used to minimize selection bias. Multilogistic regression (MLR) analysis was used to identify factors associated with haemostatic interventions. Results: A total of 20, 470 patients had blunt hepatic injuries, and 15, 235 had blunt splenic injuries, of whom 691 (3.4%) and 667 (4.4%) used preinjury aspirin, respectively. In the blunt hepatic injury cohort, there was no significant difference in the need for haemostatic procedures (TAE (6.1% vs 6.1%, p = 1.000), exploratory laparotomy (3.3% vs 4.3%, p = 0.312), hepatectomy (3.0% vs 2.7%, p = 0.686) or hepatorrhaphy (14.3% vs 15.0%, p = 0.683)). Regarding the blunt splenic injury cohort, there was no significant difference in the need for haemostatic procedures (TAE (11.5% vs 10.6%, p = 0.553), splenectomy (43.5% vs 41.4%, p = 0.230) or splenorrhaphy (3.0% vs 3.3%, p = 0.117)). An MLR analysis showed that preinjury aspirin did not increase the need for haemostatic interventions in either cohort. Conclusions: Preinjury aspirin use is not associated with increased haemostatic procedures in blunt hepatic or splenic injuries.