Head Injuries and Warfin (or not on it): data from motorcycle related views

[pellicle]

Hi

just recently there was a discussion on a fella who died after a brain bleed due to a soccer match. The paper (without evidence) attributed this to warfarin. Being a motorcyclist I take an interest in head protection (and thus helmets) probably above and beyond what most motorcyclists do (where uninformed propaganda is the rule of the day).

I was trying to answer a question on helmets to a friend and dug out this article

I thought that the following points were of relevance because there is a noted trend among head injury specialists showing that the shocks a human brain can take decrease with age. I'm sure almost none of them know what warfarin is. The AIS discussed is related to an accumulation of body injuries, but still the point remains as it is possible that a head injury could be the only injury (all others being minor).

Doctors and head-injury researchers use a simplified rating of injuries, called the Abbreviated Injury Scale, or AIS, to describe how severely a patient is hurt when they come into a trauma facility. AIS 1 means you've been barely injured. AIS 6 means you're dead, or sure to be dead very soon. Here's the entire AIS scale:
AIS 1 = Minor
AIS 2 = Moderate
AIS 3 = Serious
AIS 4 = Severe
AIS 5 = Critical
AIS 6 = Unsurvivable

... a peak linear impact—the kind we're measuring here—of 200 to 250 Gs generally corresponds to a head injury of AIS 4, or severe; that a 250 G to 300 G impact corresponds to AIS 5, or critical; and that anything over 300 Gs corresponds to AIS 6. That is, unsurvivable.

The likelihood of dying from a head injury goes up dramatically if you have other major injuries as well. It also goes up with age. ...

...You can even calculate your odds using the Injury Severity Score, or ISS. Take the AIS scores for the worst three injuries you have. Square each of those scores—that is, multiply them by themselves. Add the three results and compare them with the ISS Scale of Doom below.

A score of 75 means you're dead. Sorry. Very few people with an ISS of 70 see tomorrow either.

If you're between 15 and 44 years old, an ISS score of 40 means you have a 50-50 chance of making it. If you're between 45 and 64 years old, ISS 29 is the 50-50 mark. And above 65 years old, the 50-50 level is an ISS of 20. For a 45- to 64-year old guy such as myself, an ISS over 29 means I'll probably die.

If I get two "serious," AIS 3 injuries—the aforementioned AIS 3 head hit and AIS 3 chest thump—and a "severe" AIS 4 leg injury, my ISS score is ... let's see, 3 times 3 is 9. Twice that is 18. 4 times 4 is 16. 18 and 16 is 34. Ooops. Gotta go.

Drop my AIS 3 head injury to an AIS 2 and my ISS score is 29. Now I've got a 50-50 shot.

so before you younger group (like less than 50) blame warfarin on brain bleeds take a look at the sad (and yes, I'd like to deny it too) fact that we are all getting older...

Best Wishes