The relationship between the timing of prophylactic anticoagulation for venous thromboembolism and prognosis in the patients with high-risk traumatic brain injury
Wu Xiangwei
Sun Min
Ye Jihui
Zhu Jianhua
Abstract：Objective To investigate the relationship between the timing of prophylactic anticoagulation for venous thromboembolism(VTE)and prognosis in the patients with high-risk traumatic brain injury(TBI).Methods The clinical data of high-risk TBI patients admitted to the First Affiliated Hospital of Ningbo University from January 2018 to December 2023 were retrospectively analyzed.The patients who started anticoagulation on the 4th and 5th day post-injury were included into group A,and the patients who started anticoagulation on the 6th to 7th day post-injury were included into group B.The general clinical data and the indicators such as increased intracerebral hemorrhage,neurological deterioration,reoperation,VTE occurrence,bleeding in other parts,length of hospital stay,and mortality rate were compared between the two groups after anticoagulation.Multivariate Logistic regression analysis was used to analyze the risk factors for increased intracerebral hemorrhage and the mortality in high-risk TBI patients.Results The increase in intracerebral hemorrhage(10.0％vs.3.2％),reoperation(8.0％vs.1.6％),neurological function deterioration(9.0％vs.2.4％),and mortality rate(14.0％vs.5.6％)were significantly higher in group A than in group B respectively(P＜0.05),and the length of hospital stay was significantly longer in group A than in group B[d:16.0(13.0,19.8)vs.12.0(11.0,15.8),P＜0.05],there was no significant difference in VTE and bleeding in other sites between the two groups(all P＞0.05).Multivariate Logistic regression analysis showed that compared with group B,the risk of intracerebral hemorrhage(OR=4.715,95％CI 1.316-16.899,P＜0.05)and the risk of death(OR=3.101,95％CI 1.124-8.551,P＜0.05)was increased in group A.Conclusions It may be a good time to start prophylactic anticoagulation on the 6th to 7th day post-injury in the patients with high-risk TBI for a better prognosis.
Keywords：High-risk traumatic brain injuryVenous thromboembolismPrognosisAnticoagulation timingCerebral hemorrhage
Publication Date：2024-09-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 770-774 )