This article was published recently in the Annals of Emergency Medicine and it is causing some clinicians to radically change their practice. The study looked at patients who are on oral anticoagulants such as coumadin (warfarin) who sustain minor head injuries. The study examined the value of admitting these patients for 24 hour observation with a repeat head CT at the 24 hour mark. The study found a small proportion of patients with delayed bleeding but how much should we care about this phenomenon? We see these patients a lot- is it worth the cost to admit all of them for observation and a repeat head CT? Read the article, listen to the podcast, and then decide for yourself.
Management of Minor Head Injury in Patients Receiving Oral Anticoagulant Therapy: A Prospective Study of a 24-Hour Observation Protocol
Vincenzo, et al. Annals of Emergency Medicine June 2012. 59(6) 451-455.