Traumatic Brain Injury patients are typically given blood thinning medications to reduce the chances of developing blood clots and to improve their long-term function outlook and quality of life. Some doctors start blood thinning medications within 72 hours from injury, but other doctors prefer to delay giving these drugs for 5 days or more or not give them at all as they are worried that the drugs may increase the risk of further bleed in the brain. However, several studies have shown that following TBI, giving blood thinning medication within 72 hours of injury does not increase the risk of further bleeding. This study is designed to compare the timing of giving blood thinning medication following TBI and to guide the best practices in the future for starting blood thinning medication in order to reduce the rate of blood clots, without introducing complications from further bleeding. In this trial, we will be comparing the early initiation of blood thinning medications (within 72 hours from injury) to late initiation (deferred by a minimum of 120 hours from injury or not given at all if deemed clinically unnecessary by clinical team).
INCLUSION CRITERIA
Adult patients (≥ 16 years of age) ● Acute TBI (defined as acute traumatic changes on the CT brain, either in isolation or in the context of polytrauma) ● Patients admitted to hospital within 72 hours of injury
EXCLUSION CRITERIA
Patients with recent VTE (within 3 months before TBI) ● Known hypersensitivity to any VTE prophylaxis agents used ● Patients are not expected to live beyond 72 hours ● The time interval from injury to randomisation exceeds 72 hours ● Participation in the same study within the last 12 months ● Current use of anticoagulation for an alternative indication, with a clinical decision to continue ● Active bleeding was deemed serious enough that the treating clinical team lacked equipoise for the study question ● Progression of early traumatic intracranial haemorrhage or unstable neurological condition, such that the treating clinical team lack equipoise for the study questions
Study Information
