Early versus Late Pharmacologic Thromboprophylaxis in Traumatic Brain Injury: A Propensity-Score Matched…

Cohort studySeminars in thrombosis and hemostasis· Aug 2026

Early versus Late Pharmacologic Thromboprophylaxis in Traumatic Brain Injury: A Propensity-Score Matched Cohort Study.

Wei Jiang, Lianwei Ma, Mohamed Gamal Eldin Abd El Hamid Elashhab … Zhuonan Wang

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HematologyCohort studyTreatmentQ1IF 3.4

Starting heparin after 72 hours in traumatic brain injury was linked to more clot events

Early versus Late Pharmacologic Thromboprophylaxis in Traumatic Brain Injury: A Propensity-Score Matched Cohort Study.

Wei Jiang … Zhuonan Wang

Seminars in thrombosis and hemostasis · Aug 2026

Background

The optimal timing of pharmacological thromboprophylaxis in traumatic brain injury (traumatic brain injury) remains uncertain due to competing risks of thrombosis and bleeding.

Purpose

This study evaluated whether early heparin initiation (≤72 hours) reduces vascular occlusive events (vascular occlusive events), mortality, and hospital stay without increasing bleeding.

Methods

We compared early versus late (>72 hours) heparin use via propensity score matching (propensity score matching), subgroup analyses, and multivariable logistic regression.

Results

delayed heparin nearly doubled clot risk versus early dosing

OR 2.62 (95% CI 1.54 to 4.45)

CI excludes the null - significant

More results

Outcomes included vascular occlusive events (deep vein thrombosis, pulmonary embolism, myocardial infarction, and ischemic stroke), bleeding, 30-day and 180-day mortality, and length of stay.

More results

Subgroup analyses revealed late heparin as an independent risk factor for vascular occlusive events in mild traumatic brain injury (odds ratio 2.62, 95% confidence interval 1.54-4.45; P < .001) regardless of fracture status, coagulation profile, or hemorrhagic classification, with non-significant associations in non-hemorrhagic and moderate-to-severe traumatic brain injury subgroups.

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Conclusion

These findings suggest early heparin initiation reduces thromboembolic complications, mortality, and hospital stay without significantly increasing bleeding risk, supporting early anticoagulation in selected patients following individualized risk-benefit assessment.

Early versus Late Pharmacologic Thromboprophylaxis in Traumatic Brain Injury: A Propensity-Score Matched Cohort Study.

Early versus Late Pharmacologic Thromboprophylaxis in Traumatic Brain Injury: A Propensity-Score Matched Cohort Study.

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