Comparative Analysis of Risk Factors for Venous Thromboembolism in Patients With Traumatic Brain Injury of Different...

BackgroundVenous thromboembolism (VTE) is a major complication in patients with traumatic brain injury (TBI). However, most existing studies have focused on severe TBI, and it remains unclear whether VTE risk factors differ across injury severities.ObjectiveTo compare independent risk factors for VTE among patients with mild, moderate, and severe TBI.MethodsThis retrospective cohort study analyzed clinical data from 460 TBI patients admitted to a tertiary trauma center between January 2022 and December 2024. Patients were stratified by admission Glasgow Coma Scale (GCS) score into mild (GCS 13-15, n = 205), moderate (GCS 9-12, n = 50), and severe (GCS 3-8, n = 205) groups. VTE was screened by serial bedside Doppler ultrasonography of the upper and lower extremities. Univariate and multivariable logistic regression analyses were performed within each group to identify independent risk factors, which were then compared across groups.ResultsVTE incidence was 15.1%, 28.0%, and 49.3% in the mild, moderate, and severe TBI groups, respectively (χ² = 55.52, P < .001). Independent risk factors differed across groups: in mild TBI, length of hospital stay > 14 days (OR = 4.76) and mechanical ventilation (OR = 3.70); in moderate TBI, length of stay > 14 days (OR = 9.64), with tracheostomy showing a trend (OR = 5.68, P = .054); in severe TBI, admission fibrinogen ≥ 4 g/L (OR = 8.19), age ≥ 60 years (OR = 6.25), tracheostomy (OR = 3.56), length of stay > 14 days (OR = 3.43), surgery (OR = 2.76), and central venous catheterization (OR = 2.26). Length of stay > 14 days was the only common independent risk factor across all three groups.ConclusionVTE incidence increases substantially with TBI severity, and the spectrum of independent risk factors differs systematically across injury grades. Severity-stratified VTE prevention strategies should be considered in clinical practice.