NASHVILLE, TENNESSEE. Surgeons have long been aware that trauma patients on warfarin (Coumadin) have significantly poorer survival than do those who are not anticoagulated at the time of their accident. In order to determine more precisely exactly how dangerous being on warfarin is, Dr. Lesly Dossett and colleagues at Vanderbilt University Medical Center reviewed the records of 1,230,422 trauma patients listed in the National Trauma Databank maintained by the American College of Surgeons. They found that 36,270 of the patients were on warfarin when their trauma occurred. After adjusting for comorbidities associated with warfarin, they found that its use increased trauma-related mortality by 30%. The Vanderbilt team also noted that the use of warfarin had almost doubled in the period 2002 to 2006. Overall, 2.3% of the patient population was on warfarin in 2002 as compared to 4.0% in 2006. Among patients over the age of 65 years warfarin usage increased from 7.3% in 2002 to 12.8% in 2006.
Dossett, LA, et al. Prevalence and outcomes associated with warfarin use in injured adults. Journal of the American College of Surgeons, Vol. 209, 2009, p. S46