Risk of intracranial injury after minor head trauma in patients with pre-injury use of clopidogrel

Am J Emerg Med. 2014 Jan;32(1):71-4. doi: 10.1016/j.ajem.2013.08.063. Epub 2013 Oct 8.

Abstract

Background: Clopidogrel is an adenosine diphosphate receptor antagonist. The risk of intracranial hemorrhage following minor head trauma in patients with pre-injury use of clopidogrel has not been fully determined.

Methods: This case-controlled study examined the effects of pre-injury use of clopidogrel in adult (age 14 years and older) patients with minor head trauma.

Results: During the study period, 1660 patients head computed tomography scans were performed in the emergency department, of which 658 met inclusion criteria. Intracranial hemorrhage was noted in 30% of patients on clopidogrel, compared with 2.2% of those patients without pre-injury use of clopidogrel. After performing a logistic regression analysis for confounders, the pre-injury use of clopidogrel was significantly associated with intracranial hemorrhage in this study population (OR 16.7; 95% CI 1.71-162.7).

Conclusion: The use of clopidogrel is associated with a significantly increased risk of developing intracranial hemorrhage following minor trauma.

MeSH terms

  • Adult
  • Case-Control Studies
  • Clopidogrel
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / diagnostic imaging
  • Female
  • Humans
  • Intracranial Hemorrhage, Traumatic / chemically induced*
  • Intracranial Hemorrhage, Traumatic / diagnostic imaging
  • Male
  • Middle Aged
  • Neuroimaging
  • Platelet Aggregation Inhibitors / adverse effects*
  • Risk Factors
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives*
  • Tomography, X-Ray Computed

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine