{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T23:27:30Z","timestamp":1786750050665,"version":"build-2736575974"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"Shaanxi Provincial Postdoctoral Fellowship","award":["2023BSHYDZZ03"],"award-info":[{"award-number":["2023BSHYDZZ03"]}]},{"DOI":"10.13039\/501100007128","name":"Natural Science Foundation of Shaanxi Province","doi-asserted-by":"crossref","award":["2024SF-YBXM-387"],"award-info":[{"award-number":["2024SF-YBXM-387"]}],"id":[{"id":"10.13039\/501100007128","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100017596","name":"Natural Science Basic Research Program of Shaanxi Province","doi-asserted-by":"crossref","award":["2022JC-55"],"award-info":[{"award-number":["2022JC-55"]}],"id":[{"id":"10.13039\/501100017596","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Clinical Technology Improvement Project of the Second Hospital of Dalian Medical University","award":["2022LCJSGC08"],"award-info":[{"award-number":["2022LCJSGC08"]}]},{"name":"National Key Research and Development Program of China","award":["2023YFC3503600 and 2025YFE0215700"],"award-info":[{"award-number":["2023YFC3503600 and 2025YFE0215700"]}]},{"name":"Key Research and Development Project of the Shaanxi Provincial Health Science and Technology Innovation Capacity Enhancement Program","award":["2025YF-08"],"award-info":[{"award-number":["2025YF-08"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The optimal timing of pharmacological thromboprophylaxis in traumatic brain injury (TBI) remains uncertain due to competing risks of thrombosis and bleeding. This study evaluated whether early heparin initiation (\u226472\u2009hours) reduces vascular occlusive events (VOEs), mortality, and hospital stay without increasing bleeding. We compared early versus late (&gt;72\u2009hours) heparin use via propensity score matching (PSM), subgroup analyses, and multivariable logistic regression. Outcomes included VOEs (deep vein thrombosis, pulmonary embolism, myocardial infarction, and ischemic stroke), bleeding, 30- and 180-day mortality, and length of stay. After PSM, late heparin was associated with higher VOEs (25.16 vs. 12.24%, p\u2009&lt;\u20090.001), 30-day mortality (20 vs. 11.89%, p\u2009=\u20090.03), 180-day mortality (32.26 vs. 19.58%, p\u2009=\u20090.004), and prolonged hospitalization (median: 15.7 vs. 9.7 days, p\u2009&lt;\u20090.001), without increased bleeding risk (16.77 vs. 22.03%, p\u2009=\u20090.24). Subgroup analyses revealed late heparin as an independent risk factor for VOEs in mild TBI (odds ratio: 2.62, 95% confidence interval: 1.54\u20134.45; p\u2009&lt;\u20090.001) regardless of fracture status, coagulation profile, or hemorrhagic classification, with nonsignificant associations in nonhemorrhagic and moderate-to-severe TBI subgroups. Multivariable analysis identified late heparin, higher comorbidity index, elevated platelet count, and cranial surgery as independent predictors of VOEs, with late heparin also independently associated with increased mortality. These findings suggest early heparin initiation reduces thromboembolic complications, mortality, and hospital stay without markedly increasing bleeding risk, supporting early anticoagulation in selected patients following individualized risk-benefit assessment.<\/jats:p>","DOI":"10.1055\/a-2927-6855","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T23:09:17Z","timestamp":1786748957000},"source":"Crossref","is-referenced-by-count":0,"title":["Early versus Late Pharmacologic Thromboprophylaxis in Traumatic Brain Injury: A Propensity-Score Matched Cohort Study"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9401-5097","authenticated-orcid":false,"given":"Wei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Xi'an Jiaotong University, Shaanxi, China","place":["Xi'an"]},{"name":"The Second Hospital of Dalian Medical University, Liaoning, China","place":["Dalian"],"department":["Department of Clinical Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2769-7374","authenticated-orcid":false,"given":"Lianwei","family":"Ma","sequence":"additional","affiliation":[{"name":"The Second Hospital of Dalian Medical University, Liaoning, China","place":["Dalian"],"department":["Department of Clinical Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Gamal Eldin Abd El Hamid","family":"Elashhab","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Benha University, Egypt","place":["Banha"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8858-6816","authenticated-orcid":false,"given":"Xiang","family":"Wu","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine, Shanghai General Hospital, China","place":["Shanghai"],"department":["Department of Neurosurgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8790-5424","authenticated-orcid":false,"given":"Lijun","family":"Bai","sequence":"additional","affiliation":[{"name":"Xi'an Jiaotong University School of Life Science and Technology, Shaanxi, China","place":["Xi'an"],"department":["The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-4340","authenticated-orcid":false,"given":"Zhuonan","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China","place":["Xi'an"],"department":["PET-CT Center"]},{"name":"Xi'an Jiaotong University, Shaanxi, China","place":["Xi'an"],"department":["School of Mathematics and Statistics"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.injury.2014.01.011","article-title":"Acute traumatic coagulopathy in the setting of isolated traumatic brain injury: a systematic review and meta-analysis","volume":"45","author":"D S Epstein","year":"2014","journal-title":"Injury"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jocn.2015.11.024","article-title":"Normalization of coagulopathy is associated with improved outcome after isolated traumatic brain injury","volume":"29","author":"D S Epstein","year":"2016","journal-title":"J Clin Neurosci"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s12028-020-01037-8","article-title":"Time course of hemostatic disruptions after traumatic brain injury: a systematic review of the 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