Notice bibliographique
Résumé
Traumatic brain injuries and cardiovascular deficiencies are two of the leading causes of death in the U.S. Antithrombotics are among the common medications used for the management of cardiovascular diseases. However, the nature of antithrombotic agents makes the management of any bleeding difficult. Therefore, they are either not given to patients with a risk of bleeding, or they are stopped immediately in cases of bleeding.General guidelines in the case of intracranial hemorrhage (ICH) involve stopping the use of antithrombotics and then restarting them once the bleeding has stopped. However, unlike other types of intracranial hematomas, subdural hematomas (SDHs) are prone to rehemorrhage after a time (weeks or even months after the initial incident). Despite the prevalence of complications potentially caused by antithrombotic medications in the management of SDHs, this subject has yet to be fully investigated.This research paper documents for the first time the effects of antithrombotic therapies on patients suffering from SDHs. More specifically, we study the management of antiplatelet aggregation agents and anticoagulants in patients with traumatic SDHs. Understanding the risks of antithrombotics at different SDH stages (e.g. presence of active bleeding, presence of small or large residuals, and absence of residuals) helps to prevent potentially critical hemorrhagic complications. This thesis is a retrospective research study of patients who were admitted to the Montreal General Hospital with an acute traumatic SDH and who needed antithrombotic therapy. The study found that continuing therapeutic antiplatelet therapy while an SDH is still present, poses a high risk of rehemorrhage (45% for patients with a small residual SDH and up to 90% for those with a large residual SDH). The risk of rehemorrhage that will require neurosurgical intervention is 47%. ANTITHROMBOTIC MANAGEMENT IN ACUTE SDHOur data also shows that withholding AAA therapy for an average of 50 days, while the SDH is still present, does not contribute to any significant adverse event. We found similar results for anticoagulant therapy. The risk of rehemorrhage associated with restarting anticoagulant therapy if an SDH is not fully resolved is 28.5% and 62.5% for small and large residuals SDHs respectively. Our data shows that withholding anticoagulant therapy for an average of 67 days, while an SDH is still present, cause adverse events in only 1.1% of our study population.In the majority of cases our findings suggest that the safest course is to wait until the subdural hematoma has completely resolved before reinitiating antithrombotic therapy. At the same time, the status of the SDH should be closely monitored, using CT-scans, so that therapy can be reinitiated as soon as is safe. For patients with a high risk of thrombo-embolic events, it might be wiser to restart antithrombotic therapy while closely following-up the SDH with help of CT-scan imaging.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».