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首页> 外文期刊>Journal of Neurology Research >Safety and Efficacy of Early Pharmacologic Thromboprophylaxis in Traumatic Brain Injury
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Safety and Efficacy of Early Pharmacologic Thromboprophylaxis in Traumatic Brain Injury

机译：颅脑外伤早期药理性血栓预防的安全性和有效性

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Background: Patients with traumatic brain injury (TBI) are at an increased risk of developing venous thromboembolic events (VTE), including deep vein thromboses (DVT) and pulmonary emboli (PE). Pharmacologic thromboprophylaxis (PTP) is routinely delayed because of concerns of exacerbating intracranial hemorrhage (ICH) and worsening outcomes. We hypothesize that early PTP ( 72 h). Methods: We identified a total of 128 TBI patients who received PTP, and collected data including admission Glasgow coma scale (GCS), age, time of initiation of PTP, development of DVT or PE, progression of bleed on brain CT scan, death attributed to PTP and outcome (Glasgow outcome scale (GOS) at discharge from the hospital). Results: The 72 h group (n = 48). The 72 h group (odds ratio (OR) = 0.3; 95% confidence interval (CI) = 0.1 - 0.7, P = 0.01). There were no PEs, progression on brain CT, or deaths attributed to PTP in either group. Good neurologic outcome (GOS 4-5) was present in 35 (44%) patients in the 72 h group (OR = 2.6, 95% CI = 1.2 - 5.8, P = 0.01) (This outcome was expected and explained by the higher admission GCS in the 72 h). However, the safety and feasibility of early PTP in TBI still needs to be studied in large prospective multicenter trials, taking into account the severity of TBI, type of TBI (focal versus diffuse axonal injury), and type and dosage of PTP.J Neurol Res. 2013;3(6):169-172doi: http://dx.doi.org/10.4021/jnr255w
机译：背景：脑外伤（TBI）患者发生静脉血栓栓塞事件（VTE）的风险增加，包括深静脉血栓形成（DVT）和肺栓塞（PE）。由于担心颅内出血（ICH）加重和预后恶化，通常会推迟药理性血栓预防（PTP）。我们假设早期的PTP（72小时）。方法：我们确定了总共128名接受PTP的TBI患者，并收集了包括格拉斯哥昏迷量表（GCS），年龄，PTP起始时间，DVT或PE的发展，脑部CT扫描出血进展，归因于死亡的数据PTP和结局（出院时的格拉斯哥结局量表（GOS））。结果：72 h组（n = 48）。 72 h组（赔率（OR）= 0.3; 95％置信区间（CI）= 0.1-0.7，P = 0.01）。两组均无PE，脑CT进展或PTP致死。 72小时组中的35例（44％）患者表现出良好的神经学预后（GOS 4-5）（OR = 2.6，95％CI = 1.2-5.8，P = 0.01）（预后较高的原因可以解释） 72小时内进入GCS）。然而，仍需在大型前瞻性多中心试验中研究TBI早期PTP的安全性和可行性，同时要考虑到TBI的严重程度，TBI的类型（局灶性与弥漫性轴索损伤）以及PTP的类型和剂量.J Neurol Res。 2013; 3（6）：169-172doi：http://dx.doi.org/10.4021/jnr255w

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