To consolidate existing work on the benefits and risks of using anticoagulants after traumatic brain injuries (TBI), Ilene Harris and Zippora Kiptanui co-authored a literature review of the subject. The authors performed a literature search of terms related to TBI and anticoagulants within the following databases: MEDLINE, International Pharmaceutical Abstracts, Health Star, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) in October of 2012. The search was updated in September of 2013.
This review focused on human studies that evaluated the effects of post-TBI anticoagulation on venous thromboembolism, hemorrhage, mortality, or coagulation measures. Of the thirty-nine eligible studies identified, twenty-three had complete information on post-TBI anticoagulant use and were summarized for this systematic review. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was followed throughout the conduct of the review.
Results of the literature review reveal that TBI patients with stabilized hemorrhagic patterns can safely be treated with pharmacological thromboprophylaxis. However, the need for more evidence regarding effectiveness of this technique in preventing venous thromboembolism persists. More evidence is also required to establish preferred agent, dose, and timing for pharmacological thromboprophylaxis.