{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:43:28Z","timestamp":1788335008986,"version":"build-2803163510"},"reference-count":26,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chemical prophylaxis using low-molecular-weight heparin (LMWH) is considered a standard of care for venous thromboembolism in trauma patients. Our center performs a head computed tomography (CT) scan 24 hours after initiation with prophylactic LMWH in the setting of a known traumatic brain injury (TBI). The purpose was to determine the overall incidence of ICH progression after chemoprophylaxis in patients with a TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study was performed at a Level I trauma center, from 1\/1\/2014 to 12\/31\/2017. Study patients were drawn from the institution\u2019s trauma registry based on Abbreviated Injury Score codes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>778 patients met all inclusion criteria after initial chart review. The proportion of patients with an observed radiographic progression of intracranial hemorrhage after LMWH was 5.8%. 3.1% of patients had a change in clinical management. Observed radiographic progression after LMWH prophylaxis and the presence of SDH on initial CT, the bilateral absence of pupillary response in the emergency department, and a diagnosis of dementia were found to have statistically significant correlation with bleed progression after LMWH was initiated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Over a 4-year period, the use of CT to evaluate for radiographic progression of traumatic intracranial hemorrhage 24 hours after receiving LMWH resulted in a change in clinical management for 3.1% of patients. The odds of intracranial hemorrhage progression were approximately 6.5\u00d7 greater in patients with subdural hemorrhage on initial CT, 3.1\u00d7 greater in patients with lack of bilateral pupillary response in ED, and 4.2\u00d7 greater in patients who had been diagnosed with dementia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348211054078","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T07:45:53Z","timestamp":1637221553000},"page":"894-900","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Progression of Intracranial Hemorrhage After Chemical Prophylaxis Using Low-Molecular-Weight Heparin in Patients With Traumatic Brain Injury"],"prefix":"10.1177","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1472-0784","authenticated-orcid":false,"given":"Zachary T.","family":"Thier","sequence":"first","affiliation":[{"name":"Lincoln Memorial University DeBusk College of Osteopathic Medicine, Knoxville, TN, USA"},{"name":"Department of Orthopaedic Surgery, University of South Carolina School of Medicine, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelan","family":"Drake-Lavelle","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"Department of Emergency Medicine, Prisma Health \u2013 Upstate, Greenville, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3156-7814","authenticated-orcid":false,"given":"Phillip J.","family":"Prest","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"Division of Trauma, Surgical Critical Care, and Emergency General Surgery, Department of Surgery, Prisma Health Richland, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8286-1549","authenticated-orcid":false,"given":"Mark A.","family":"Jones","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"Division of Trauma, Surgical Critical Care, and Emergency General Surgery, Department of Surgery, Prisma Health Richland, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8740-7513","authenticated-orcid":false,"given":"Jeremy M.","family":"Reeves","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"Division of Trauma, Surgical Critical Care, and Emergency General Surgery, Department of Surgery, Prisma Health Richland, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9065-8946","authenticated-orcid":false,"given":"Catherine F.","family":"McClung-Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prisma Health \u2013 Midlands, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6861-1364","authenticated-orcid":false,"given":"Tyler M.","family":"Goodwin","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"Department of Orthopedic Surgery, University of Tennessee Health Science Center, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nolan","family":"Villani","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"Department of Orthopedic Surgery, Eisenhower Army Medical Center, Fort Gordon, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Metz","sequence":"additional","affiliation":[{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"Department of Orthopaedic Surgery, Naval Medical Center, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9444-087X","authenticated-orcid":false,"given":"J. Benjamin","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of South Carolina School of Medicine, Columbia, SC, USA"},{"name":"University of South Carolina School of Medicine, Columbia, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"bibr1-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016683970"},{"key":"bibr2-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.017"},{"key":"bibr3-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2016.06.049"},{"key":"bibr4-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199412153312401"},{"key":"bibr5-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000137138.40116.6c"},{"key":"bibr6-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000697"},{"key":"bibr7-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200207000-00032"},{"key":"bibr8-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.3963"},{"key":"bibr9-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2010.1366"},{"key":"bibr10-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609053351003"},{"key":"bibr11-00031348211054078","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.2-132.v1"},{"key":"bibr12-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2297"},{"key":"bibr13-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200207000-00032"},{"key":"bibr14-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199609000-00010"},{"key":"bibr15-00031348211054078","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.206646"},{"key":"bibr16-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.6.696"},{"key":"bibr17-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31818a0e74"},{"issue":"2","key":"bibr18-00031348211054078","first-page":"396","volume":"71","author":"Minshall CT","year":"2011","journal-title":"J Trauma"},{"key":"bibr19-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31820b5d22"},{"key":"bibr20-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318265cab9"},{"key":"bibr21-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2014.3366"},{"key":"bibr22-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2012.2459"},{"key":"bibr23-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182606327"},{"key":"bibr24-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2014.12.016"},{"key":"bibr25-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2017.07.012"},{"key":"bibr26-00031348211054078","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.09.063"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348211054078","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348211054078","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348211054078","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:34:52Z","timestamp":1777379692000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348211054078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,18]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1177\/00031348211054078"],"URL":"https:\/\/doi.org\/10.1177\/00031348211054078","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,18]]}}}