title: Deep vein thrombosis and pulmonary embolus in patients with traumatic brain injury: a prospective observational study.
abstract: BACKGROUND
  Intensive care patients with traumatic brain injury (TBI) are at high risk of developing deep vein thrombosis (DVT). A high rate of DVT was reported before routine thromboprophylaxis, but the current DVT rate in TBI patients receiving best-practice mechanical and pharmacological prophylaxis is unknown.
  
  
  OBJECTIVE
  To determine the prevalence of DVT among TBI patients.
  
  
  METHODS
  A prospective observational pilot study of adult patients admitted to the intensive care unit of a level 1 trauma centre within 72 hours of sustaining a TBI (Glasgow Coma Scale score _14).
  
  
  METHODS
  Rate of DVT determined using twice-weekly compression ultrasound; rate of pulmonary embolism (PE) and length of stay.
  
  
  RESULTS
  36 patients (28 men; mean age, 40.3 years) were included. Six had moderate and 21 had severe TBI. Two patients (6%) developed a DVT and two patients (6%) developed a PE. The proximal leg DVT rate was 3%, but the overall venous thromboembolism rate was 11% (4 patients).
  
  
  CONCLUSIONS
  Mechanical and pharmacological prophylaxis appeared to be effective. The incidence of clinically identified PE is of concern and suggests that thromboembolic sources other than large leg veins may not be being adequately controlled by modern thromboprophylaxis regimens.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Praeger
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Westbrook
authors.forename: Alistair D
authors.initials: AD
authors.lastname: Nichol
authors.forename: Ruwan
authors.initials: R
authors.lastname: Wijemunige
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Davies
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Lyon
authors.forename: Judy L
authors.initials: JL
authors.lastname: Wills
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Rosenfeld
authors.forename: D James
authors.initials: DJ
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001315:Australia; D001930:Brain Injuries / Q000150:complications*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology* / Q000628:therapy; D020246:Venous Thrombosis / Q000209:etiology* / Q000628:therapy; D055815:Young Adult
chemical_list: D000925:Anticoagulants