{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T17:19:30Z","timestamp":1765473570718,"version":"3.48.0"},"reference-count":43,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: While direct oral anticoagulants (DOACs) are widely used, robust evidence for low-energy trauma is scarce. Studies have shown similar or better outcomes of traumatic brain injury (TBI) under DOAC therapy compared to vitamin K antagonists, but there is limited data on the differences among DOAC types. Methods: We performed a retrospective study of TBI patients with pre-injury DOACs who presented to our level 1 trauma unit and received cranial computed tomography. Only low-energy trauma mechanisms were included. Results: We included 643 patients with an average age of 82 years. As per the Glasgow Coma Scale, 637 patients (99.1%) had a mild TBI and 34 patients (5.3%) had intracranial hematomas. No delayed intracranial bleeding occurred during in-hospital observation. Rivaroxaban was the most frequent DOAC (278, 43.2%), followed by apixaban (221, 34.4%), dabigatran (84, 13.1%), and edoxaban (60, 9.3%). Neurosurgical interventions were performed in three cases (0.5%). The head injury-related in-hospital mortality was 0.9% (six patients). Fisher\u2019s Exact Test and regression analysis did not demonstrate statistically significant differences among the DOAC types regarding occurrence of intracranial bleeding, surgical interventions, or mortality. Conclusions: We found no statistically significant differences between DOACs regarding complications of TBI after low-energy trauma. This study shows an overall low risk of complications after low-energy trauma in a predominantly geriatric population with TBI and DOAC therapy.<\/jats:p>","DOI":"10.3390\/jcm14248787","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T17:13:34Z","timestamp":1765473214000},"page":"8787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Different DOACs on Complications of TBI After Low-Energy Trauma"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2294-649X","authenticated-orcid":false,"given":"Anna","family":"Antoni","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Puhl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Wedrich","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Klinik Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-4278","authenticated-orcid":false,"given":"Matthias","family":"Millesi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1697-1381","authenticated-orcid":false,"given":"Valerie","family":"Weihs","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Schwendenwein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silke","family":"Aldrian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0935-5281","authenticated-orcid":false,"given":"Stefan","family":"Hajdu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2174\/1874325001509010361","article-title":"Low Energy Trauma in Older Persons: Where to Next?","volume":"9","author":"Chehade","year":"2015","journal-title":"Open Orthop. 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