Grant: Project Grant

Severe traumatic brain injury is common, potentially lethal, and can result in severe and irreversible disability. It is also often associated with potentially life-threatening complications during the early period following the injury, when patients are critically ill and receiving life support. One of these complications is the development of clots in the legs and the lungs because the patients are not moving. Injectable clot prevention medications (anticoagulants) can help prevent these clots from forming, but there is a risk that these may increase the risk of progression of brain bleeding early after the injury. Currently, there is debate about the best timing to start these medications: as soon as possible during the first week after the brain injury, or waiting until at least 7 days after the brain injury. This study will help doctors determine which of these two approaches is better: early use of the medications to reduce the risk of clot, versus withholding these medications until one week after the brain injury to reduce the risk of bleeding. Both of these options have competing risks and benefits. This study will involve 11 of the largest major Canadian Trauma hospitals, and will provide valuable information to help improve outcomes for these critically ill patients.