Which traumatic brain injury patients should be treated with anticoagulants and when?

Raychaudhuri, Ratul; Litofsky, N. Scott

doi:10.1586/14737175.2014.888652

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…LMWH was shown to be superior to heparin in a double-blinded, randomized clinical trial among 344 trauma patients without frank intracranial bleeding 27 . The initial enoxaparin dose for trauma patients may also be based on weight like 0.5 mg/kg twice daily, or 30 mg for 50 to 60 kg patients, 40 mg for 61 to 99 kg patients, and 50 mg for patients greater than 100 kg 29,30 . The advantages of using LMWH compared to other modalities are its ease of administration, increased e cacy, improved speci city, and no monitoring requirement 31 .…”

Section: Discussionmentioning

confidence: 99%

DVT Prophylaxis in head-injured patients: Current Concepts and Guidelines

Bakhsh,

Ali,

Aljuzair.

et al. 2023

Preprint

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Objective: DVT prophylaxis is often delayed in head -injured patients because clinicians believe that the risk of bleeding from prophylaxis is more critical than the risk of venous thromboembolism. Material & Methods: All head injury admissions between September 2021 and September 2022 were selected for inclusion in this study. Patient data including age, sex, injuries, Glasgow Coma Scale, Injury Severity Score, were collected. Chemical prophylaxis, either heparin or enoxaparin, was started as soon as it was considered safe. Patients with traumatic intracranial hemorrhage were followed up with brain computed tomography to examine the safety of chemical DVT prophylaxis. Results: A cohort of 100 patients was studied during the one year study period. Their average GCS scores and Injury Severity Score scores were 11 and 14 respectively. Overall, 68% of patients suffered from mild to moderate head injuries. Fifty-nine percent of patients were poly-traumatized with different types of extracranial injuries. 60% were managed conservatively and 40% needed surgical intervention. Overall, 75% of patients received chemical DVT prophylaxis and 25% received mechanical prophylaxis. 50% received early chemoprophylaxis, that is within 72 hours, 25% received late prophylaxis, that is after 72 hours. The average delay in start of DVT prophylaxis was 2.9 days. 2.4% of patients developed DVT in spite of prophylaxis but no one developed any expansion of intracranial hemorrhage . Conclusion: This study concluded that early DVT prophylaxis in head-injured patients is safe and effective.

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Section: Discussionmentioning

confidence: 99%

DVT Prophylaxis in head-injured patients: Current Concepts and Guidelines

Bakhsh,

Ali,

Aljuzair.

et al. 2023

Preprint

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“…The study results highlight clinical implications of health status transition in TBI, which necessitate integration of primary and secondary preventive practices into the care of individual patients. Despite challenges associated with limited reimbursement and time 94 , skepticism about patients' commitment to change 95 , and conflicting professional recommendations 96 , 97 , preventive practices fall under direct clinical provision of health promoting strategies and prophylactic treatment 98 .…”

Section: Discussionmentioning

confidence: 99%

Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event

Mollayeva

Tran

Chan

et al. 2022

Sci Rep

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For centuries, the study of traumatic brain injury (TBI) has been centred on historical observation and analyses of personal, social, and environmental processes, which have been examined separately. Today, computation implementation and vast patient data repositories can enable a concurrent analysis of personal, social, and environmental processes, providing insight into changes in health status transitions over time. We applied computational and data visualization techniques to categorize decade-long health records of 235,003 patients with TBI in Canada, from preceding injury to the injury event itself. Our results highlighted that health status transition patterns in TBI emerged along with the projection of comorbidity where many disorders, social and environmental adversities preceding injury are reflected in external causes of injury and injury severity. The strongest associations between health status preceding TBI and health status at the injury event were between multiple body system pathology and advanced age-related brain pathology networks. The interwoven aspects of health status on a time continuum can influence post-injury trajectories and should be considered in TBI risk analysis to improve prevention, diagnosis, and care.

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“…Reviewing studies, we found that the chemical thromboprophylaxis based on low-dose subcutaneous low molecular weight (40 mg/day) or unfractionated heparin (2500–5000 UI/12h) significantly reduces the incidence of VTE in TBI patients with a stable or improved head CT after 24 hours and does not enhance the risk of intracranial hemorrhage development [ [18] , [19] , [20] ].…”

Section: Discussionmentioning

confidence: 99%