{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T02:05:50Z","timestamp":1789005950540,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Falls are the leading cause of injury in older individuals, with intracranial hemorrhage (ICH) being a common complication. Anticoagulants, such as vitamin K antagonist and direct oral anticoagulants, are increasingly utilized, and clinicians may question the necessity of reversal in patients with minor ICH, especially in the setting of increased risk of adverse events. This study aimed to identify a population of patients with minor traumatic ICH at low risk for poor\u2010neurologic status where anticoagulant reversal may not improve outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study utilized data accessed from 35 trauma centers from 2018 to 2021. Patients included had a preinjury anticoagulant regimen, ICH due to blunt trauma, Glasgow Coma Scale score of 15, an Abbreviated Injury Scale (AIS) head score from 2 to 4, and an AIS of \u22641 for non\u2010head regions within 24\u2009h of hospital arrival. Patients were excluded if they required an emergent neurosurgical procedure or were on a preinjury purinergic\u2010P2 receptor\u201012 protein (P2Y12) inhibitor. The primary outcome was the rate of in\u2010hospital mortality or hospice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 654 patients on preinjury anticoagulation who were included with a minor traumatic ICH without neurologic deficits. Overall, 263 patients were reversed and 391 were not reversed. Twelve (4.6%) patients with in\u2010hospital mortality or hospice were reversed compared with 19 (4.91%) patients who were not reversed (<jats:italic>p<\/jats:italic>\u2009=\u20090.861). A composite of hospital complications occurred in 21 (8%) reversed patients and 34 (8.7%) not reversed patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.748). The average intensive care unit length of stay was 1.4\u2009\u00b1\u20093.4\u2009days in the reversed group and 1.1\u2009\u00b1\u20091.8\u2009days in the not reversed group (<jats:italic>p<\/jats:italic>\u2009=\u20090.069).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study found no difference in hospital outcomes between patients with minor traumatic ICH on oral anticoagulants who were neurologically intact that were reversed versus those who were not reversed. Further studies should continue to define the subset of traumatic ICH patients who may not require reversal of anticoagulation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2901","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T03:34:30Z","timestamp":1703302470000},"page":"241-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Is reversal of anticoagulants necessary in neurologically intact traumatic intracranial hemorrhage?"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7836-059X","authenticated-orcid":false,"given":"Kelly","family":"Powell","sequence":"first","affiliation":[{"name":"Trinity Health Ann Arbor  Ypsilanti Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"William","family":"Curtiss","sequence":"additional","affiliation":[{"name":"Trinity Health Ann Arbor  Ypsilanti Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Sadek","sequence":"additional","affiliation":[{"name":"Trinity Health Ann Arbor  Ypsilanti Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2853-3162","authenticated-orcid":false,"given":"Jason","family":"Hecht","sequence":"additional","affiliation":[{"name":"Trinity Health Ann Arbor  Ypsilanti Michigan 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