INCIDENCE AND SEQUELAE OF SYMPTOMATIC VENOUS THROMBOEMBOLIC DISEASE AMONG PATIENTS WITH TRAUMATIC BRAIN INJURY

Venous thromboembolism (VTE) is a potentially life-threatening complic ation among patients with traumatic brain injury (TBI). However, few r eports describe the incidence of this important disease. We reviewed t he incidence of symptomatic VTE among 124 consecutive admissions with TBI to a free-standing rehabilitation hospital over an 18-month period . Four patients manifested evidence of VTE within 2 months of injury: two with leg swelling, one with an oedematous arm, and one with respir atory distress. None of the patients with suspected VTE received proph ylactic anticoagulant therapy. Diagnosis of VTE was confirmed with ven ograph in two of the four patients. Although VTE is frequently asympto matic, the incidence of symptomatic VTE (1.6%) among this series of re habilitation inpatients with TBI still appears surprisingly low. These results have implications regarding the utility of non-invasive diagn ostic screening of asymptomatic VTE and routine anticoagulant prophyla xis of high-risk patients with TBI.