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Timing for deep vein thrombosis chemoprophylaxis in traumatic brain injury: an evidence-based review

Overview of attention for article published in Critical Care, December 2015
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

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59 tweeters
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1 Facebook page

Citations

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40 Dimensions

Readers on

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82 Mendeley
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Title
Timing for deep vein thrombosis chemoprophylaxis in traumatic brain injury: an evidence-based review
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0814-z
Pubmed ID
Authors

Hiba Abdel-Aziz, C Michael Dunham, Rema J Malik, Barbara M Hileman

Abstract

Multiple studies have addressed deep vein thrombosis chemoprophylaxis timing in traumatic brain injuries. However, a precise time for safe and effective chemoprophylaxis is uncertain according to experts. A comprehensive literature review on brain injuries was performed to delineate temporal proportions for 1) spontaneous intracranial hemorrhage (ICH) progression, 2) post-chemoprophylaxis ICH expansion, and 3) post-chemoprophylaxis deep vein thrombosis. Twenty-three publications were found including more than 5,000 patients. Spontaneous ICH expansion at 24 hours was 14.8% in 1,437 patients from chemoprophylaxis studies and 29.9% in 1,257 patients not in chemoprophylaxis studies (P < 0.0001). With low-risk ICH (n = 136), 99% of spontaneous ICH expansion occurred within 48 hours. In moderate or high-risk ICH (n = 109), 18% of spontaneous ICH expansion occurred after day 3. If patients with pre-chemoprophylaxis ICH expansion are included, the post-chemoprophylaxis ICH expansion proportion was 5.6% in 1,258 patients with chemoprophylaxis on days 1 to 3 and was 1.5% in 401 with chemoprophylaxis after day 3 (P = 0.0116). If patients with pre-chemoprophylaxis ICH expansion were excluded, the post-chemoprophylaxis ICH expansion proportion was 3.1% in 1,570 patients with chemoprophylaxis on days 1 to 3 and was 2.8% in 582 with chemoprophylaxis after day 3 (P = 0.7769). In diffuse axonal injury (n = 188), the post-chemoprophylaxis ICH expansion proportion was 1.6% with chemoprophylaxis after day 3. The deep vein thrombosis proportions were as follows: chemoprophylaxis on days 1 to 3, 2.6% in 2,384 patients; chemoprophylaxis on days 4 or 5, 2.2% in 831; and chemoprophylaxis on day 8, 14.1% in 99 (P < 0.0001). Spontaneous ICH expansion proportions at 24 hours substantially vary between chemoprophylaxis and non-chemoprophylaxis studies. Chemoprophylaxis should not be given within 3 days of injury for moderate-risk or high-risk ICH. Chemoprophylaxis is reasonable when low-risk patients have not developed ICH expansion within 48 hours post-injury. Chemoprophylaxis is also acceptable after day 3, when low-risk patients develop ICH expansion within 48 hours post-injury. In diffuse axonal injury patients who have not developed ICH within 72 hours, chemoprophylaxis is reasonable. Deep vein thrombosis proportions significantly increase when chemoprophylaxis is withheld for greater than 7 days.

Twitter Demographics

The data shown below were collected from the profiles of 59 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 82 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 2%
South Africa 1 1%
Germany 1 1%
United Kingdom 1 1%
Mexico 1 1%
Spain 1 1%
Unknown 75 91%

Demographic breakdown

Readers by professional status Count As %
Other 15 18%
Researcher 11 13%
Student > Master 10 12%
Student > Postgraduate 10 12%
Student > Bachelor 8 10%
Other 19 23%
Unknown 9 11%
Readers by discipline Count As %
Medicine and Dentistry 59 72%
Neuroscience 4 5%
Pharmacology, Toxicology and Pharmaceutical Science 2 2%
Social Sciences 1 1%
Arts and Humanities 1 1%
Other 1 1%
Unknown 14 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 33. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 March 2018.
All research outputs
#819,816
of 18,925,350 outputs
Outputs from Critical Care
#713
of 5,535 outputs
Outputs of similar age
#12,961
of 234,617 outputs
Outputs of similar age from Critical Care
#1
of 36 outputs
Altmetric has tracked 18,925,350 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,535 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.3. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 234,617 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 36 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.