JAMA Logo Warfarin, the commonly employed anticoagulant apparently restricts blood clot formation. This anticoagulant may be recommended for long-term management and prevention of thromboembolic. A recent study claims that warfarin users have a significantly increased risk of death after traumatic injuries.

The study was carried out on the information accumulated by the National Trauma Databank. It included data about more than 1.2 million individuals admitted in trauma centers between 2002 and 2007. 36,270 patients forming 3 percent and 26,841 patients older than 65 representing 9 percent were warfarin users. The number of people employing warfarin supposedly elevated from 2.3 percent in 2002 to 4 percent by 2006. Among those above the age of 65, warfarin usage increased from 7.3 percent in 2002 to 12.8 percent by 2006.

Authors quote, “The most profound impact is among younger patients with head injuries. While older patients with severe head injuries have high mortality rates whether or not they are warfarin users, warfarin use increases the mortality from severe head injuries by 50 percent in patients younger than 65 years. These data support other reports that suggest that patients who undergo pre-injury anticoagulation with warfarin are at increased risk of death after trauma. Warfarin prescribers should consider these data in the overall risk-benefit analysis when opting to prescribe warfarin, and these data provide further rationale for discontinuing warfarin when the clinical evidence no longer supports its use.”

9.3 percent patients using warfarin and 4.8 percent non-users presumably had a higher likelihood of dying from their injuries. 87 percent warfarin users and 96 percent non-users may have had greater chances of blunt mechanism injuries in the home or residential institutions. Those employing warfarin appeared more likely to be admitted with intracranial hemorrhage. Lesly A. Dossett, M.D., M.P.H., of Vanderbilt University Medical Center, Nashville, Tenn., and colleagues noted that 22 percent warfarin users and 18 percent non-users had a considerably raised threat of death. However, those 65 years and above did not report any difference in the risk of death between both the groups.

The study will be published in the May print issue of Archives of Surgery, one of the JAMA/Archives journals.