Grewal K, et al. CMAJ. 2021 Oct 12;193(40):E1561-E1567.
Question and Methods: Retrospective cohort study evaluating risk of ICH post head injury in ED patients >65 years on warfarin or DOAC or no anticoagulant.
Findings: Patients on warfarin had an increased risk of ICH compared with matched patients on DOACs (RR 1.43, 95% CI 1.20–1.69) and no anticoagulation (RR 1.36, 95% CI 1.15–1.61). No difference in ICH between patients not on anticoagulation and DOACS.
Limitations: No laboratory data to evaluate coagulation markers
Interpretation: Patients on warfarin with head injury had higher relative risk of ICH than matched patients on DOAC and no anticoagulation.
Supervision: Dr. Jeff Perry
Dr. Graham Wilson is a FRPCP Emergency Medicine resident at the University of Ottawa with a passion for the outdoors, and sustainable environmental change.
Dr. Perry is an Emergency Physician and full Professor in the department of Epidemiology and Community Medicine. He has a special research interest in subarachnoid hemorrhage, TIA and stroke.
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.