The risk factors, outcomes, and costs associated with venous thromboembolism after traumatic brain injury: a nationwide analysis. (6th December 2019)

• Record Type: Journal Article
• Authors: Hoffman, Haydn; Jalal, Muhammad S.; Chin, Lawrence S.
• Is Part Of: Brain injury. Volume 33:Number 13/14(2019)
• Page Start: 1671
• Page End: 1678
• Publication Date: 2019-12-06
• Subjects: Traumatic brain injury -- venous thromboembolism -- venous thrombosis -- pulmonary embolism; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2019.1667536
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective : We sought to identify risk factors for VTE following traumatic brain injury (TBI) and determine how venous thromboembolism (VTE) affects outcomes and costs using a national database. Methods : The Nationwide Inpatient Sample (NIS) was used to identify patients with TBI between 2002 and 2014. VTE was identified as any occurrence of deep venous thrombosis or pulmonary embolism. We investigated putative risk factors for VTE and determined the effect of VTE on outcomes including mortality and disposition. Results : 424, 929 patients met the inclusion criteria. There were 16, 690 (3.9%) patients who developed a VTE. The annual incidence of VTE increased from 2.2% in 2002 to 5.4% in 2014 ( R 2 = 0.992, p < .001). Older age, increasing number of comorbidities, craniotomy or craniectomy, and more severe injuries were associated with increased odds of developing VTE ( p < .001 for all). Patients with VTE had decreased odds of in-hospital mortality (OR 0.53; 95% CI 0.50–0.57) and increased odds of non-routine disposition (OR 2.05; 95% CI 1.97–2.14), tracheostomy, and gastrostomy. Conclusion : To our knowledge, we provide the largest analysis of VTE in TBI. This entity appears to be increasing in frequency, which may merit new strategies for prevention.