Abstract TMP90: Prevention of Stroke in Traumatic Cerebrovascular Injury With Aspirin Carries an Increased Risk of Transfusion

Introduction: Traumatic extracranial carotid or vertebral artery injury (TCVI) occurs in about 1% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 2,400 strokes annually in the U.S. Screening CT angiography (CTA) of trauma patients is ubiquitous, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Although prophylaxis with these agents is thought to be safer than anticoagulation, which carries a sgnificant risk of hemorrhage in trauma patients, their risk of hemorrhagic complications is unknown. Methods: Single-center retrospective cohort study of patients with a screening CTA after admission for blunt trauma. Patients with CTA indicating TCVI were treated routinely with aspirin 325 mg daily. Risk of transfusion ≥1 unit of packed red blood cells (PRBC) >24 hours after admission (excluding transfusions during injury-related blood loss) was assessed according to CTA findings (CTA+ or CTA-) ...