Preferences in traumatic intracranial hemorrhage: bleeding vs. clotting.
Patients with traumatic brain injury and resultant intracranial hemorrhage (ICH) are at high risk for developing venous thromboembolism (VTE). The use of thromboprophylaxis is effective at decreasing the rate of VTE, but at the potential expense of an increased risk of ICH progression. Physicians must carefully consider both the benefits and risks of VTE prophylaxis before prescribing chemical anticoagulants to these patients. To help clarify this difficult choice, Scales and colleagues performed a decision analysis to determine whether the benefits of thromboprophylaxis outweigh the potential risk of worsening ICH. There is increasing evidence that bleeding risks are not as prominent as previously thought. Although the results were largely inconclusive, the present study has identified areas for future research.
Chan
Chee M
CM
Division of Pulmonary and Critical Care Medicine, Washington Hospital Center, 110 Irving Street NW #2B-39, Washington, DC 20010, USA. chee262@hotmail.com
Zilberberg
Marya D
MD
D001777:Blood Coagulation / Q000187:drug effects*; D003661:Decision Support Techniques; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000188:drug therapy* / Q000503:physiopathology; D018570:Risk Assessment; D013923:Thromboembolism / Q000517:prevention & control