Jakob, Dominik A.; Lewis, Meghan; Benjamin, Elizabeth R; Mitchao, Delbrynth P; Exadaktylos, Aristomenis K; Demetriades, Demetrios (2022). Timing of venous thromboembolic pharmacological prophylaxis in traumatic combined subdural and subarachnoid hemorrhage. American journal of surgery, 223(6), pp. 1194-1199. Elsevier Science 10.1016/j.amjsurg.2021.11.021
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BACKGROUND
The combination of subdural and subarachnoid hemorrhage is the most common intracranial bleeding. The present study evaluated the timing and type of venous thromboembolic chemoprophylaxis (VTEp) for efficacy and safety in patients with blunt head trauma with combined acute subdural and subarachnoid hemorrhage.
METHODS
Patients with isolated combined acute subdural and subarachnoid hemorrhage were extracted from the ACS-TQIP database (2013-2017). After 1:1 cohort matching of patients receiving early prophylaxis (EP, ≤48 h) versus late prophylaxis (LP, >48 h) outcomes were compared with univariable and multivariable regression analysis.
RESULTS
Multivariable regression analysis identified EP as an independent protective factor for VTE complications (OR 0.468, CI 0.293-0.748) but not mortality (p = 0.485). The adjusted risk for delayed craniectomy was not associated with EP compared to LP (p = 0.283). The type of VTEp was not associated with VTE complications (p = 0.301), mortality (p = 0.391) or delayed craniectomy (p = 0.126).
CONCLUSIONS
Early VTEp (≤48 h) was associated with fewer VTE complications in patients and did not increase the risk for craniectomies in patients with combined acute subdural and subarachnoid hemorrhage.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center |
UniBE Contributor: |
Jakob, Dominik, Exadaktylos, Aristomenis |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0002-9610 |
Publisher: |
Elsevier Science |
Language: |
English |
Submitter: |
Romana Saredi |
Date Deposited: |
13 Jan 2022 12:10 |
Last Modified: |
05 Dec 2022 15:58 |
Publisher DOI: |
10.1016/j.amjsurg.2021.11.021 |
PubMed ID: |
34809908 |
Uncontrolled Keywords: |
Prophylaxis Subarachnoid hemorrhage Subdural hematoma Venous thromboembolism |
BORIS DOI: |
10.48350/162765 |
URI: |
https://boris.unibe.ch/id/eprint/162765 |
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