People who sustain a traumatic brain injury (TBI) are at high risk for developing deep vein thrombosis (DVT) and pulmonary embolism (PE). PE is a leading cause of death in these patients. But blood-thinning medications started within 72 hours of hospital arrival have a significant protective effect against these conditions in patients with severe TBI, and do not increase risk of bleeding complications or death, according to study results published online as an “article in press” on the Journal of the American College of Surgeons website in advance of print publication.
Researchers found that early initiation of prophylaxis was associated with significantly lower rates of PE and DVT. The odds of both PE and DVT were 50 percent lower in the early prophylaxis group than in the late prophylaxis group. Importantly, there was no difference with respect to rates of late neurosurgical interventions or in-hospital death between early prophylaxis and late prophylaxis groups. “Our findings suggest that this is possible without increasing the risk of the most feared complications, such as the need to take a patient to the operating room to evacuate intracranial hemorrhage, or death. In other words, it’s possible to prevent PE or DVT with early prophylaxis, without putting patients at risk of bad outcomes, and we should be striving to achieve this,” he concluded.