Deep venous thrombosis management following traumatic brain injury: a practice survey of the traumatic brain injury model systems.
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).


METHODS
e-mail survey instrument.


METHODS
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.
Carlile
Mary C
MC
Department of Physical Medicine and Rehabilitation, Baylor Institute for Rehabilitation, Dallas, TX 75246, USA. MaryCar@BaylorHealth.edu
Yablon
Stuart A
SA
Mysiw
W Jerry
WJ
Frol
Alan B
AB
Lo
David
D
Diaz-Arrastia
Ramon
R
D001510:Bed Rest / Q000706:statistics & numerical data; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D019538:Health Care Surveys; D006801:Humans; D010818:Practice Patterns, Physicians'; D016306:Vena Cava Filters / Q000706:statistics & numerical data; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*