Early initiation of venous thromboembolism prophylaxis appeared associated with decreased risk for pulmonary embolism and deep vein thrombosis in patients with severe traumatic brain injury, according to results of an observational study. Early initiation of prophylaxis did not confer increased risk for death or late neurosurgical intervention.
The researchers conducted a propensity-matched cohort study that included 3,634 patients (median age, 43 years; 77% men) with severe TBI. Early prophylaxis appeared associated with lower rates of PE (OR = 0.48; 95% CI, 0.25-0.91) and DVT (OR = 0.51; 95% CI, 0.36-0.72). “In patients with severe traumatic brain injury, early initiation of pharmacologic VTE prophylaxis (< 72 hours) was associated with significantly lower rates of PE and DVT compared [with] late prophylaxis, with no increased risk [for] late neurosurgical intervention or death. VTE prophylaxis should be initiated early, within 72 hours of hospital arrival, in the context of appropriate patient risk stratification.”