Short Tilte:Deep venous thrombosis management following traumatic brain injury: A practice survey of the traumatic brain injury model systems
Journal:Journal of Head Trauma Rehabilitation
Year, Volume, Issue, Page(s):06, 21, 6, 483-490
Objective: To determine national patterns of screening, prophylaxis, and treatment of deep venous
thrombosis (DVT) following traumatic brain injury (TBI) within the Traumatic Brain Injury
Model Systems (TBIMS). Design: e-mail survey instrument. Setting: Multicenter Regional TBIMS.
Results: Fifteen of the 16 rehabilitation centers within the TBIMS responded to the survey (94%
response rate). Approximately half of these centers routinely screen to detect subclinical DVTs
(56% venous duplex ultrasonography, 12% plasma D-dimer) on admission to inpatient rehabilitation.
Fifty-six percent of respondents use anticoagulation prophylactically, while 69% use mechanical
means for DVT prophylaxis. Eighty fatal pulmonary emboli were reported for TBI patients in
189 practice-years, corresponding to 0.42 fatalities per year of practice. Conclusions: No consensus
exists regarding the optimal methods for screening, prevention, or treatment of DVT in TBI
patients in the acute rehabilitation setting of the TBIMS. The number of fatal pulmonary emboli
reported among these centers emphasizes the need to develop evidence-based clinical practice
guidelines for the prevention and treatment of venous thromboembolism in this patient population.