Trauma patients on new oral anticoagulation agents have lower mortality than those on warfarin.

Background: Although anticoagulation with warfarin has been associated with increased risk of adverse outcomes after trauma, the effects of the new oral agents (NOA) such as dabigatran, apixaban, rivaroxaban are not yet well characterized. Methods: A retrospective review of a Level 1 trauma center database identified all patients age >= 50 admitted after trauma during a 24 month period starting September 2013. Demographics, including pre-admission anticoagulation agents, injuries, hospital course and outcomes were abstracted from the EMR. Results: Over the 24 month period, 3392 patients were admitted; 112 (3.3%) were anticoagulated with NOA and 373 (11.0%) with warfarin with a trend toward increasing utilization of the new agents compared to warfarin over that time period. Although comparable in age, ISS and mechanism of injury, patients anticoagulated with warfarin had both a higher overall mortality (10.9%) compared to the NOA (6.25%) and the non-anticoagulated control (5.5%) groups (p

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