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- Title
Early Chemoprophylaxis Against Venous Thromboembolism in Patients With Traumatic Brain Injury.
- Authors
Rivas, Lisbi; Vella, Michael; Ju, Tammy; Fernandez-Moure, Joseph S.; Sparks, Andrew; Seamon, Mark J.; Sarani, Babak
- Abstract
<bold>Introduction: </bold>Timing to start of chemoprophylaxis for venous thromboembolism (VTE) in patients with traumatic brain injury (TBI) remains controversial. We hypothesize that early administration is not associated with increased intracranial hemorrhage.<bold>Methods: </bold>A retrospective study of adult patients with TBI following blunt injury was performed. Patients with penetrating brain injury, any moderate/severe organ injury other than the brain, need for craniotomy/craniectomy, death within 24 hours of admission, or progression of bleed on 6 hour follow-up head computed tomography scan were excluded. Patients were divided into early (≤24 hours) and late (>24 hours) cohorts based on time to initiation of chemoprophylaxis. Progression of bleed was the primary outcome.<bold>Results: </bold>264 patients were enrolled, 40% of whom were in the early cohort. The average time to VTE prophylaxis initiation was 17 hours and 47 hours in the early and late groups, respectively (P < .0001). There was no difference in progression of bleed (5.6% vs. 7%, P = .67), craniectomy/-craniotomy rate (1.9% vs. 2.5%, P = .81), or VTE rate (0% vs. 2.5%, P = .1).<bold>Conclusion: </bold>Early chemoprophylaxis is not associated with progression of hemorrhage or need for neurosurgical intervention in patients with TBI and a stable head CT 7 hours following injury.
- Subjects
THROMBOEMBOLISM prevention; DISEASE progression; ENOXAPARIN; RESEARCH; VEINS; PULMONARY embolism; BLUNT trauma; INTRACRANIAL hemorrhage; TIME; RESEARCH methodology; ANTICOAGULANTS; RETROSPECTIVE studies; EVALUATION research; DRUG administration; VENOUS thrombosis; COMPARATIVE studies; THROMBOEMBOLISM; LOW-molecular-weight heparin; HEPARIN; COMPUTED tomography; CRANIOTOMY; CHEMOPREVENTION; DISCHARGE planning; DISEASE complications
- Publication
American Surgeon, 2022, Vol 88, Issue 2, p187
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/0003134820983171