PMID- 36479363
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221210
IS  - 2689-288X (Electronic)
IS  - 2689-288X (Linking)
VI  - 3
IP  - 1
DP  - 2022
TI  - Timing and Type of Venous Thromboembolic Chemoprophylaxis Is Associated with 
      Acute Traumatic Brain Injury Outcomes.
PG  - 511-521
LID - 10.1089/neur.2022.0048 [doi]
AB  - Venous thromboembolic (VTE) prophylaxis in acute traumatic brain injury (TBI) is 
      a controversial topic with wide practice variations. This study examined the 
      association of VTE chemoprophylaxis with inpatient mortality and VTE events among 
      isolated TBI patients. This was a retrospective cohort study of 87 trauma centers 
      within a large hospital system in the United States analyzing 23,548 patients 
      with isolated TBI, 7977 of whom had moderate-to-severe TBI. Primary outcomes were 
      inpatient mortality and VTE events. The control group received no 
      chemoprophylaxis. Other groups received low-molecular-weight heparin (LMWH), 
      unfractionated heparin (UFH), and combined LMWH and UFH chemoprophylaxis. 
      Multi-variable regression accounted for confounders. Outcomes were stratified by 
      timing of administration, body mass index (BMI), and TBI type. Patients without 
      VTE prophylaxis had the least VTE events. LMWH had the lowest mortality for both 
      all-isolated and moderate-to-severe isolated TBI populations at adjusted odds 
      ratio (aOR) 0.24 (95% confidence interval [CI], 0.14-0.43) and aOR 0.25 (95% CI, 
      0.14-0.44), respectively. Clinically significant progression of TBI was lowest 
      among the LMWH group (0.1%; p value, 0.001). After stratifying by timing of VTE 
      chemoprophylaxis, only patients with subdural hematoma and LMWH between 6 and 
      24 h (N = 62), as well as patients with >/=35 BMI and LMWH between 6 and 24 h 
      (N = 65) or >24-48 h (N = 54), had no VTE events. VTE chemoprophylaxis timing may 
      have prevented VTE in certain subgroups of isolated TBI patients. Though VTE 
      chemoprophylaxis did not prevent VTE for most TBI patients, LMWH VTE 
      chemoprophylaxis was associated with reduced mortality.
CI  - (c) Darwin Ang et al., 2022; Published by Mary Ann Liebert, Inc.
FAU - Ang, Darwin
AU  - Ang D
AD  - Department of Trauma, HCA Florida Ocala Hospital, Ocala, Florida, USA.
AD  - Department of Surgery, University of South Florida, Tampa, Florida, USA.
AD  - College of Medicine, University of Central Florida, Orlando, Florida, USA.
FAU - Pierre, Kevin
AU  - Pierre K
AD  - Department of Trauma, HCA Florida Ocala Hospital, Ocala, Florida, USA.
AD  - College of Medicine, University of Central Florida, Orlando, Florida, USA.
FAU - Armstrong, John
AU  - Armstrong J
AD  - Department of Surgery, University of South Florida, Tampa, Florida, USA.
FAU - Dunne, James
AU  - Dunne J
AD  - Department of Surgery, Medical Center, Memorial Health University, Savannah, 
      Georgia, USA.
FAU - Flaherty, Stephen
AU  - Flaherty S
AD  - Department of Trauma, Del Sol Medical Center, El Paso, Texas, USA.
FAU - Gonzalez, Ernest
AU  - Gonzalez E
AD  - Department of Trauma, South Austin Medical Center, Austin, Texas, USA.
FAU - McKenney, Mark
AU  - McKenney M
AD  - Department of Trauma, Kendall Regional Medical Center, Miami, Florida, USA.
FAU - Offner, Patrick
AU  - Offner P
AD  - Department of Trauma, Sky Ridge Medical Center, Lone Tree, Colorado, USA.
FAU - Plurad, David
AU  - Plurad D
AD  - Department of Trauma, Riverside Community Hospital, Riverside, California, USA.
FAU - Liu, Huazhi
AU  - Liu H
AD  - Department of Trauma, HCA Florida Ocala Hospital, Ocala, Florida, USA.
FAU - Ziglar, Michele
AU  - Ziglar M
AD  - Clinical Services Group, Hospital Corporation of America, Nashville, Tennessee, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20221110
PL  - United States
TA  - Neurotrauma Rep
JT  - Neurotrauma reports
JID - 101773091
PMC - PMC9718434
OTO - NOTNLM
OT  - chemoprophylaxis
OT  - low-molecular-weight heparin
OT  - mortality
OT  - traumatic brain injury
OT  - unfractionated heparin
OT  - venous thromboembolic events
COIS- No competing financial interests exist.
EDAT- 2022/12/09 06:00
MHDA- 2022/12/09 06:01
PMCR- 2022/11/10
CRDT- 2022/12/08 14:04
PHST- 2022/12/08 14:04 [entrez]
PHST- 2022/12/09 06:00 [pubmed]
PHST- 2022/12/09 06:01 [medline]
PHST- 2022/11/10 00:00 [pmc-release]
AID - 10.1089/neur.2022.0048 [pii]
AID - 10.1089/neur.2022.0048 [doi]
PST - epublish
SO  - Neurotrauma Rep. 2022 Nov 10;3(1):511-521. doi: 10.1089/neur.2022.0048. 
      eCollection 2022.