OPtimal Timing of Thromboprophylaxis in Traumatic IntraCranial Haemorrhage (OPTTTICH Feasibility Study)
Status:
Completed
Trial end date:
2013-12-01
Target enrollment:
Participant gender:
Summary
Victims of trauma with severe head injury who have bled into their brains are at high risk of
developing blood clots in their legs. These blood clots can break off and travel through the
bloodstream to the lungs causing death. Blood thinners can be given to patients to prevent
blood clots from developing but this can leave patients at risk for additional bleeding in
the brain causing further damage or death. The earlier blood thinners are started the more
effective they are at preventing blood clots but some patients with severe head injury who
have bled into their brains will develop further bleeding even if they do not receive blood
thinners. Even though a growing body of research has shown that the majority of bleeding in
the brain stops within the first 24 hours after injury and that it is safe to start blood
thinners as early as 24 hours after injury, doctors are still waiting longer than 4 days to
start blood thinners in these patients over concerns of worsening bleeding. In Canada, almost
half of the patients with severe head injury do not receive blood thinners until at least
five days after injury. Delays in starting blood thinners appear to put patients at increased
risk of developing blood clots, unnecessarily. This study will compare the benefits of
starting low-molecular weight heparin (LMWH), a type of blood thinner, early (less than 48
hours) versus the current practice (waiting until the 5th day after being injured) in
preventing blood clots in patients who have bled into their brains after severe head injury.
The investigators believe that starting LMWH earlier will be more effective in preventing
blood clots without worsening any bleeding when compared to waiting to start blood thinners.
This study is called OPTTTICH (Optimal Timing of Thromboprophylaxis in Traumatic IntraCranial
Haemorrhage) and will be the largest Canadian investigator-initiated randomized control trial
on blood clot prevention in trauma patients with severe head injury who have bled into their
brains.