J Korean Soc Emerg Med.  2024 Jun;35(3):231-238.

Comparison of blood amount following single antiplatelet therapy and dual antiplatelet therapy in patients with traumatic acute subdural hemorrhage

• Lee YE
• Sun KH

Abstract

Objective
Many patients with traumatic subdural hemorrhage visit the emergency room, and many elderly patients are taking antiplatelets. This study compared the difference in the increase in subdural hemorrhage in patients according to the antiplatelet therapy method.
Methods
Patients with traumatic acute subdural hemorrhage among patients who visited the emergency room were investigated. The study was designed by dividing the subjects into five groups: a non-drug group, single antiplatelet therapy groups (aspirin, clopidogrel, and cilostazol), and a dual antiplatelet therapy group. Statistical analysis was carried out using SPSS version 27.0. A P-value <0.05 is considered significant.
Results
Comparing 249 patients with cerebral hemorrhage thickness and central cerebral line movement on follow-up brain computed tomography performed on the subjects through analysis of variance, cerebral hemorrhage thickness and central cerebral line movement were 1.39±1.61 mm and 0.67±1.29 mm in the non-drug group; 1.45±1.65 mm and 0.71±1.44 mm in the aspirin group; 1±1.31 mm and 0.2±0.61 mm in the clopidogrel group; 1.26±1.34 mm and 1.22± 1.84 mm in the cilostazol group; and 5.97±6.18 mm and 3.36±3.93 mm in the dual antiplatelet therapy (DAPT) group. As a result, the F-value of the five groups of cerebral hemorrhage thickness was 21.47 (P=0.000), and the cerebral midline shift was 15.17 (P=0.000)
Conclusion
The amount of cerebral hemorrhage in DAPT was significantly higher than in the non-drug group and single antiplatelet therapy. Furthermore, there is a need to establish screening guidelines through additional research on predicting delayed cerebral hemorrhage in head trauma patients with antiplatelet therapy who did not have a cerebral hemorrhage when visiting an emergency medical center.

Keyword

Traumatic brain injuries; Subdural hematoma; Dual anti-platelet therapy