{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:33:12Z","timestamp":1781627592610,"version":"3.54.5"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Severe traumatic brain injury (TBI) with acute subdural hematoma (SDH) is common in neurosurgical care. Especially due to demographic development, it becomes increasingly coincident with preexisting therapeutic anticoagulation and comorbidity, such as atrial fibrillation or coagulative disorders. High-velocity trauma mechanisms become rarer, while low-impact trauma to the skull with acute-on-chronic subdural hemorrhage gets relatively more frequent. In this study we elucidate the timing of perioperative prophylactic AC and its influence on morbidity and mortality as well as complications after neurosurgical treatment. We focused especially on postoperative intracranial hemorrhage (PH) and thromboembolic events (TE). For this retrospective data analysis, 259 patients who suffered from severe TBI with consecutive subdural hematoma between 01\/01\/2014 and 31\/12\/2019 were included. We followed up for the length of stay. We assessed various biographical and clinical data for risk factors and focused on the connection between time-point of AC and adverse events. Subgroup analyses were performed for TE and PH that either required surgical intervention or was managed conservatively with radiological follow-up. Statistical analysis was performed using receiver operating characteristic curve analyses, Mann-Whitney U Test, Chi-square test, Fisher\u2019s exact test and univariate binomial logistic regression. P-values below 0.05 were considered statistically significant. TE were relatively rare in this cohort (<jats:italic>n<\/jats:italic>\u2009=\u200914, 5.4%). The more common adverse event was PH (<jats:italic>n<\/jats:italic>\u2009=\u200934, 13.1%), with a total of 28 patients (10.8%) needing surgical revision. Though PH was correlated to a delay in AC (<jats:italic>p<\/jats:italic>\u2009=\u20090.010), there was no correlation between early prophylactic AC and PH (<jats:italic>p<\/jats:italic>\u2009=\u20090.287) or TE (<jats:italic>p<\/jats:italic>\u2009=\u20090.444), respectively. Furthermore, only 4 patients had been administered AC before the PH. In this context, AC was delayed purposely after PH, explaining the significant correlation between PH and delayed AC. Occurrence of PH significantly decreased overall survival (<jats:italic>p<\/jats:italic>\u2009=\u20090.022), while TE did not (<jats:italic>p<\/jats:italic>\u2009=\u20090.357). Prophylactic AC within 24\u201348\u00a0h after surgery did not result in more frequent PH. Our data on AC timing suggest that PH is not caused by prophylactic AC.<\/jats:p>","DOI":"10.1038\/s41598-025-93981-8","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T16:02:16Z","timestamp":1742400136000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prophylactic anticoagulation in traumatic subdural hematoma"],"prefix":"10.1038","volume":"15","author":[{"given":"Florian","family":"Wilhelmy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordian","family":"Prasse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00f6rge","family":"Bastian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Meixensberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdem","family":"G\u00fcresir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Wende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kasper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"93981_CR1","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.3171\/2017.10.JNS17352","volume":"130","author":"MC Dewan","year":"2019","unstructured":"Dewan, M. C. et al. Estimating the global incidence of traumatic brain injury. J. Neurosurg. 130, 1080\u20131097. https:\/\/doi.org\/10.3171\/2017.10.JNS17352 (2019).","journal-title":"J. Neurosurg."},{"key":"93981_CR2","doi-asserted-by":"publisher","unstructured":"Naylor, R. M. et al. High Long-Term Mortality Rate in Elderly Patients with Mild Traumatic Brain Injury and Subdural Hematoma due to Ground-Level Fall: Neurosurgery\u2019s Hip Fracture. World Neurosurg. ; 167:e1122-e1127. (2022). https:\/\/doi.org\/10.1016\/j.wneu.2022.08.140. PMID: 36075357.","DOI":"10.1016\/j.wneu.2022.08.140"},{"key":"93981_CR3","doi-asserted-by":"publisher","unstructured":"Maas, A. I. R. et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. ; 21:1004\u201360. (2022). https:\/\/doi.org\/10.1016\/S1474-4422(22)00309-X. PMID: 36183712.","DOI":"10.1016\/S1474-4422(22)00309-X"},{"key":"93981_CR4","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1055\/s-0040-1702178","volume":"46","author":"M Maegele","year":"2020","unstructured":"Maegele, M. et al. Changes in coagulation following brain injury. Semin Thromb. Hemost. 46, 155\u2013166. https:\/\/doi.org\/10.1055\/s-0040-1702178 (2020).","journal-title":"Semin Thromb. Hemost."},{"key":"93981_CR5","doi-asserted-by":"publisher","unstructured":"B\u00f6hm, J. K. et al. Extended Coagulation Profiling in Isolated Traumatic Brain Injury: A CENTER-TBI Analysis. Neurocrit Care. ; 36:927\u201341. Epub 2021\/12\/16. (2022). https:\/\/doi.org\/10.1007\/s12028-021-01400-3. PMID: 34918214.","DOI":"10.1007\/s12028-021-01400-3"},{"key":"93981_CR6","doi-asserted-by":"publisher","unstructured":"Hannadjas, I. et al. Prothrombin complex concentrate (PCC) for treatment of trauma-induced coagulopathy: systematic review and meta-analyses. Crit Care. ; 27:422. (2023). https:\/\/doi.org\/10.1186\/s13054-023-04688-z. PMID: 37919775.","DOI":"10.1186\/s13054-023-04688-z"},{"key":"93981_CR7","doi-asserted-by":"publisher","unstructured":"Chen, P. et al. Risk factors associated with the progression of extra-axial hematoma in the original frontotemporoparietal site after contralateral decompressive surgery in traumatic brain injury patients. Chin J Traumatol. ; 23:45\u201350. (2020). https:\/\/doi.org\/10.1016\/j.cjtee.2019.10.005. PMID: 31982270.","DOI":"10.1016\/j.cjtee.2019.10.005"},{"key":"93981_CR8","doi-asserted-by":"publisher","unstructured":"Byrne, J. P. et al. Association of Venous Thromboembolism Prophylaxis After Neurosurgical Intervention for Traumatic Brain Injury With Thromboembolic Complications, Repeated Neurosurgery, and Mortality. JAMA Surg. ; 157:e215794. (2022). https:\/\/doi.org\/10.1001\/jamasurg.2021.5794. 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Sci Rep. ; 13:21679. (2023). https:\/\/doi.org\/10.1038\/s41598-023-48542-2. PMID: 38066037.","DOI":"10.1038\/s41598-023-48542-2"},{"key":"93981_CR12","doi-asserted-by":"publisher","unstructured":"Wilhelmy, F. et al. Perioperative anticoagulation in patients with intracranial meningioma: No increased risk of intracranial hemorrhage. PLoS One. ; 15:e0238387. (2020). https:\/\/doi.org\/10.1371\/journal.pone.0238387. PMID: 32870937.","DOI":"10.1371\/journal.pone.0238387"},{"key":"93981_CR13","doi-asserted-by":"publisher","unstructured":"Hantsche, A. et al. Early prophylactic anticoagulation after subarachnoid hemorrhage decreases systemic ischemia and improves outcome. Clin Neurol Neurosurg. ; 207:106809. (2021). https:\/\/doi.org\/10.1016\/j.clineuro.2021.106809. PMID: 34274657.","DOI":"10.1016\/j.clineuro.2021.106809"},{"key":"93981_CR14","unstructured":"Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften. S3-Leitlinie: Prophylaxe der ven\u00f6sen Thrombembolie. 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