Additional Associated Factors for Venous Thromboembolism in Patients with Traumatic Brain Injury

Excerpt

We read with great interest the article by Cole et al. [1], in which the authors aimed to identify critical factors that can influence the development of venous thromboembolism (VTE) in patients with traumatic brain injury (TBI). In their article, the authors mentioned a number of preexisting risk factors for VTE, however, a few important risk factors are still missing. History of hormone therapy is the one of the major risk factors for occurrence of VTE in female patients, as oral estrogen is found to have a higher risk of VTE compared with transdermal patch [2]. It would be interesting to know how many patients with TBI had diabetes mellitus (DM). The risk of developing VTE is 1.4 times higher among patients with DM than patients without DM [3]. Although the authors mentioned the details of chemoprophylaxis in these patients, they should have also noted the number of patients who received mechanical thromboprophylaxis along with chemoprophylaxis. According to Cochrane database systemic review, the combining of mechanical with chemoprophylaxis, compared with chemoprophylaxis alone, reduces the incidence of both pulmonary embolism and deep vein thrombosis [4]. In their article, the authors mentioned the injury severity score, but they did not grade the TBI severity. It would also be interesting to know the incidence of VTE in different TBI categories. …