دورية أكاديمية
Early venous thromboembolism chemoprophylaxis in traumatic brain injury requiring neurosurgical intervention: Safe and effective.
| العنوان: | Early venous thromboembolism chemoprophylaxis in traumatic brain injury requiring neurosurgical intervention: Safe and effective. |
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| المؤلفون: | Al Tannir AH; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI. Electronic address: https://twitter.com/tannir_abed., Golestani S; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Tentis M; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Murphy PB; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Schramm AT; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Peschman J; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Dodgion C; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Holena D; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Miranda S; Department of Neurology, University of Pennsylvania, Philadelphia, PA., Carver TW; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., de Moya MA; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI., Schellenberg M; Department of Surgery, Division of Trauma and Critical Care Surgery, University of Southern California, Los Angeles, CA., Morris RS; Department of Surgery, Division of Trauma and Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI. Electronic address: ramorris@mcw.edu. |
| المصدر: | Surgery [Surgery] 2024 May; Vol. 175 (5), pp. 1439-1444. Date of Electronic Publication: 2024 Feb 21. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 0417347 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-7361 (Electronic) Linking ISSN: 00396060 NLM ISO Abbreviation: Surgery Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: St. Louis, MO : Mosby Original Publication: St. Louis. |
| مواضيع طبية MeSH: | Venous Thromboembolism*/etiology , Venous Thromboembolism*/prevention & control , Venous Thromboembolism*/epidemiology , Brain Injuries, Traumatic*/complications , Brain Injuries, Traumatic*/surgery, Humans ; Anticoagulants/adverse effects ; Intracranial Hemorrhages/etiology ; Retrospective Studies ; Chemoprevention/adverse effects |
| مستخلص: | Background: Traumatic brain injury patients who require neurosurgical intervention are at the highest risk of worsening intracranial hemorrhage. This subgroup of patients has frequently been excluded from prior research regarding the timing of venous thromboembolism chemoprophylaxis. This study aims to assess the efficacy and safety of early venous thromboembolism chemoprophylaxis in patients with traumatic brain injuries requiring neurosurgical interventions. Methods: This is a single-center retrospective review (2016-2020) of traumatic brain injury patients requiring neurosurgical intervention admitted to a level I trauma center. Interventions included intracranial pressure monitoring, subdural drain, external ventricular drain, craniotomy, and craniectomy. Exclusion criteria included neurosurgical intervention after chemoprophylaxis initiation, death within 5 days of admission, and absence of chemoprophylaxis. The total population was stratified into Early (≤72 hours of intervention) versus Late (>72 hours after intervention) chemoprophylaxis initiation. Results: A total of 351 patients met the inclusion criteria, of whom 204 (58%) had early chemoprophylaxis initiation. Overall, there were no significant differences in baseline and admission characteristics between cohorts. The Early chemoprophylaxis cohort had a statistically significant lower venous thromboembolism rate (5% vs 13%, P < .001) with no increased risk of worsening intracranial hemorrhage (10% vs 13%, P = .44) or neurosurgical reintervention (8% vs 10%, P = .7). On subgroup analysis, a total of 169 patients required either a craniotomy or a craniectomy before chemoprophylaxis. The Early chemoprophylaxis cohort had statistically significant lower venous thromboembolism rates (2% vs 11%, P < .001) with no increase in intracranial hemorrhage (8% vs 11%, P = .6) or repeat neurosurgical intervention (8% vs 10%, P = .77). Conclusion: Venous thromboembolism prophylaxis initiation within 72 hours of neurosurgical intervention is safe and effective. Further prospective research is warranted to validate the results of this study. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| المشرفين على المادة: | 0 (Anticoagulants) |
| تواريخ الأحداث: | Date Created: 20240222 Date Completed: 20240410 Latest Revision: 20240410 |
| رمز التحديث: | 20240410 |
| DOI: | 10.1016/j.surg.2024.01.026 |
| PMID: | 38388229 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-7361 |
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| DOI: | 10.1016/j.surg.2024.01.026 |