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A meta-analysis to determine the effect of pre-injury warfarin on mortality in trauma patients*

The aim of this meta-analysis was to determine the effect and magnitude of effect of pre-injury warfarin on trauma patients. Studies comparing all trauma patients (nb. not head injury patients only) on pre-injury warfarin to all trauma patients not on pre-injury warfarin were included in the meta-analysis. The search was performed using Medline via the PubMed interface; no limits were placed on the language. Ten papers were found to be suitable for the meta-analysis. There were two case control studies and eight retrospective cohort (nested case control) studies. Significant heterogeneity was present as measured by the Q test (Q value = 126.366 df = 9, p = 0.000) and also the I2 test (I2 = 92.878). The preferred model for this meta-analysis was considered to be the Fixed effect model which produced a common OR 1.952 (95% CI; 1.888–2.018, p = 0.000). The results of this meta-analysis show that pre-injury warfarin does increase mortality in trauma patients by an odds ratio of nearly two.