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Patterns of Different Classes of Oral Anticoagulants and Antiplatelets Among Elderly Fall Patients at a Level I Trauma Center
*Rickesha L Wilson¹, *Shan-Estelle Brown², *Garry Lapidus², *Jacqueline McQuay², *Eric Klein³, D'Andrea Joseph^3
1University of Connecticut Health, Farmington, CT;²Injury Prevention Center, Hartford, CT;³Hartford Hospital, Department of Trauma Surgery, Hartford, CT

Objective: To evaluate patterns of OAC and antiplatelet use and their effect on outcomes in the geriatric trauma population who experience falls. Design: Retrospective review of a Trauma Registry. Setting: Level 1 Trauma Center. Patients: Elderly patients (≥ 65) who had fallen from January 1, 2010 to December 31, 2014 were included. Interventions: None. Main Outcome Measures: Data collected included demographics, medication history at the time of fall, injury severity score, and outcomes such as length of stay and disposition. Results: Approximately 2,950 patients met initial criteria of fall and elderly. Of these, 798 were on an OAC or antiplatelet drug. Two thirds of patients (537) were 80+ years of age, (mean =82.77, SD ± 8.68, range = 65-89+), 501 female, 297 male, and 92% (731) white. Inpatient mortality was 5% with an average LOS of 6.26 days (± 4.6) and average ISS of 10.37 (± 6.29). The most common isolated injuries were pelvic (43%), head (11%) and vertebral (8%). Approximately 23% of patients were taking only warfarin, 2% were taking only a newer OAC, 69% antiplatelet, and 6% a combination of an OAC and antiplatelet. From 2010 to 2014, the percentage of patients on a newer OAC at time of fall increased by 4%. Increased ISS was associated with increased OAC and antiplatelet drugs but this did not reach statistical significance. Conclusions: There has been an increase in the prescription of OAC and antiplatelet drugs in the elderly population. ISS appears to increase with the number of OAC and antiplatelet medication used although not significantly. Further studies are needed to evaluate the role of this class of drugs in patient outcomes after falls.

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