Prehospital use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduced incidence of trauma-induced coagulopathy.

Neal MD, Brown JB, Moore EE, et al.
Ann Surg 2014; Jan 13 [Epub ahead of print].
NATA Rating :
Review by : J. Stensballe
NATA Review

Neal and colleagues, on behalf of The Inflammation and the Host Response to Injury Investigators, add important information to the knowledge on trauma-induced coagulopathy (TIC). Inflammation appears to be linked to the coagulopathy in trauma, and pre-trauma use of nonsteroidal anti-inflammatory drugs (NSAIDs) reduces this risk.

In 1897 severely injured trauma patients, TIC, defined as an admission INR > 1.5, or clinically significant coagulopathy, defined as the need for transfusion of more than 2 units of FFP or 1 unit of platelets in the first 6 hours after admission, were investigated in relation to pre-trauma administration of 15 drugs. In a multivariate model, after relevant adjustments, only NSAIDs reduced the risk of coagulopathy in trauma, supporting the evidence that inflammation is an important part of this disease burden.

The next important challenge will be to test the hypotheses generated here.

– Jakob Stensballe