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J Korean Soc Emerg Med > Volume 35(3); 2024 > Article
Journal of The Korean Society of Emergency Medicine 2024;35(3): 231-238.
외상성 급성 경막하출혈 환자에서의 단일 항혈소판제 요법 및 이중 항혈소판제 요법에 따른 출혈량 변화에 대한 고찰
이용의 , 선경훈
조선대학교병원 응급의학과
Comparison of blood amount following single antiplatelet therapy and dual antiplatelet therapy in patients with traumatic acute subdural hemorrhage
Yong Eui Lee , Kyung Hun Sun
Department of Emergency Medicine, Chosun University Hospital, Gwangju, Korea
Correspondence  Kyung Hun Sun ,Tel: 062-220-3285, Fax: 062-224-3501, Email: skhkorea@hanmail.net,
Received: September 1, 2023; Revised: October 13, 2023   Accepted: October 18, 2023.  Published online: June 30, 2024.
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.
Method:
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.
Key words: Traumatic brain injuries; Subdural hematoma; Dual anti-platelet therapy
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