Deep vein thrombosis in non-anticoagulated head injury patients

The aim of this study was to evaluate the risk of DVT in a group of head-injury patients admitted to the intensive care unit (ICU) at Asir Central Hospital (ACH), Abha, Saudi Arabia, without mechanical or anticoagulant prophylaxis against DVT. During the period from January 1998 to March 1999, we evaluated 103 lower limbs in 54 such patients. 37(69%) patients presented with isolated head injury, while 17(31%) had other associated injuries. The mean age for the whole group was 29.9 years (range 8-70), with only one female patient. All patients underwent both clinical and continuous wave Doppler (CWD) examination on or after the 7th day post-trauma. 42(78%) patients had also D-dimer (latex) assay done at the same time. Although all the limbs were soft on clinical examination, 4(4%) were swollen and 7 (7%) were edematous. CWD examination was normal for all the limbs. 35 out of the 42 patients who had D-dimer testing (83%), showed high positive D-dimer concentration (500 - 1000 ng/ml), indicating the presence of thrombosis. We, therefore, recommend closer monitoring of these patients and application of prophylactic measures against DVT especially in the presence of associated injuries.