The analysis was adjusted to eliminate the effect that factors such as race, ethnicity, gender and severity of injury could have on the findings.
The risk associated with warfarin has been noticed by emergency room doctors for about the last five years, but this study is important because it involves such a large number of patients, said Dr. Pratik Doshi, director of emergency critical care at Memorial Hermann Texas Medical Center in Houston.
"It is looking at 1.2 million encounters. No one has been able to do it at the level this study does," said Doshi, noting that previous studies showing similar problems with the drug had only about 80 or 90 subjects.
"It's nice to see this in a setting where it has real credibility," said Doshi, who is also an assistant professor of emergency medicine and internal medicine at the University of Texas Health Science Center, Houston. "There can be no argument now."
Griffin and Doshi said they would like to see continued research to find out how to reduce the risk of death in this group of patients.
Doshi said his trauma center has procedures in place to make sure doctors know when a trauma patient is on warfarin, but a lot of smaller hospitals might not.
Citing pressures the health-care system places on doctors to see more patients in less time, he said "the price we pay" is that often physicians aren't able to carefully explain the risk associated with warfarin.
"That conversation probably doesn't happen as often as it should," said Doshi, adding that "even a fall from a standing position can be very significant" for an elderly person on warfarin.
People who take the drug should discuss the risks with family members so they can inform doctors should an injury occu
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