Abstract | INTRODUCTION: METHODS: 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. RESULTS: 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). CONCLUSION: 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.
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Authors | Lisbi Rivas, Michael Vella, Tammy Ju, Joseph S Fernandez-Moure, Andrew Sparks, Mark J Seamon, Babak Sarani |
Journal | The American surgeon
(Am Surg)
Vol. 88
Issue 2
Pg. 187-193
(Feb 2022)
ISSN: 1555-9823 [Electronic] United States |
PMID | 33502231
(Publication Type: Journal Article, Multicenter Study)
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Chemical References |
- Anticoagulants
- Factor Xa Inhibitors
- Heparin, Low-Molecular-Weight
- Heparin
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Topics |
- Adult
- Anticoagulants
(administration & dosage)
- Brain Injuries, Traumatic
(complications, mortality)
- Chemoprevention
- Craniotomy
(statistics & numerical data)
- Disease Progression
- Drug Administration Schedule
- Factor Xa Inhibitors
(administration & dosage)
- Heparin
(administration & dosage)
- Heparin, Low-Molecular-Weight
(administration & dosage)
- Humans
- Intracranial Hemorrhages
(diagnostic imaging, etiology)
- Middle Aged
- Patient Discharge
(statistics & numerical data)
- Pulmonary Embolism
(epidemiology, prevention & control)
- Retrospective Studies
- Time Factors
- Tomography, X-Ray Computed
- Venous Thromboembolism
(epidemiology, mortality, prevention & control)
- Venous Thrombosis
(epidemiology, prevention & control)
- Wounds, Nonpenetrating
(complications)
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