ArticleJournal of neurotrauma2014
The Parkland Protocol's modified Berne-Norwood criteria predict two tiers of risk for traumatic brain injury progression.
Article in Journal of neurotrauma, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Venous thromboembolic events in traumatic brain injury. Does timing of prophylaxis matter? A single-center retrospective cohort study.Proceedings (Baylor University. Medical Center) · 2026Article
- Elderly at a Crossroads: Rehabilitation and Hospice Outcomes in Small Traumatic Brain Injuries.Clinical medicine & research · 2026Article
- Age Matters: Unveiling the Impact of Traumatic Brain Injury Size and Type on Outcomes in Middle-Aged and Elderly Patients.Clinical medicine & research · 2026Article
- An Exploratory Analysis of Chemical and Mechanical VTE Prophylaxis in Patients with High Rebleeding Risk Traumatic Brain Injury.Neurocritical care · 2026Article
- Optimizing venous thromboembolism prophylaxis timing in ventilated traumatic brain injury patients: a retrospective cohort study using ACS-TQIP data (2017-2021).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Early (<24 hours) venous thromboembolism prophylaxis in traumatic brain injury: development of the EViTBI algorithm using a national cohort.Trauma surgery & acute care open · 2026Article
- Quality Improvement of Venous Thromboembolism Prophylaxis in Neurological Surgery: Ochsner Health System Protocol.JMIR research protocols · 2025Article
- Leveraging Dual Usability Methods to Evaluate Clinical Decision Support Among Patients With Traumatic Brain Injury: Mixed Methods Study.JMIR human factors · 2025Article
- Venous thromboembolism prophylaxis in adults with acute traumatic brain injury: a systematic review.Trauma surgery & acute care open · 2025Article
- A pragmatic, stepped-wedge, hybrid type II trial of interoperable clinical decision support to improve venous thromboembolism prophylaxis for patients with traumatic brain injury.Implementation science : IS · 2024Article
- Severe Traumatic Brain Injury and Pulmonary Embolism: Risks, Prevention, Diagnosis and Management.Journal of clinical medicine · 2024Review
- Management of Antithrombotic Drugs in Patients with Isolated Traumatic Brain Injury: An Intersociety Consensus Document.Neurocritical care · 2024Article
- Early administration of high dose enoxaparin after traumatic brain injury.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Saudi Critical Care Society clinical practice guidelines on the prevention of venous thromboembolism in adults with trauma: reviewed for evidence-based integrity and endorsed by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine.Annals of intensive care · 2023Review
- Article
- Venous thromboembolism prophylaxis in the trauma intensive care unit: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document.Trauma surgery & acute care open · 2021Article
- Early Chemical Thromboprophylaxis Does not Increase the Risk of Intracranial Hematoma Progression in Patients with Isolated Severe Traumatic Brain Injury.World journal of surgery · 2019Article
- Practice Patterns of Inferior Vena Cava Filter Placement and Factors That Predict Retrieval Rates: A Single-Center Institution and Review of the Literature.Journal of clinical medicine research · 2018Article
- Routine repeat head CT may not be necessary for patients with mild TBI.Trauma surgery & acute care open · 2018Article
- The Insertion and Management of External Ventricular Drains: An Evidence-Based Consensus Statement : A Statement for Healthcare Professionals from the Neurocritical Care Society.Neurocritical care · 2016Review
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Authors and funding
8 authors.
Funding
Abstract
As a basis for venous thromboembolism (VTE) prophylaxis after traumatic brain injury (TBI), we have previously published an algorithm known as the Parkland Protocol. Patients are classified by risk for spontaneous progression of hemorrhage with chemoprophylaxis regimens tailored to each tier. We sought to validate this schema. In our algorithm, patients with any of the following are classified "low risk" for spontaneous progression: subdural hemorrhage ≤8 mm thick; epidural hemorrhage ≤8 mm thick; contusions ≤20 mm in diameter; a single contusion per lobe; any amount of subarachnoid hemorrhage; or any amount of intraventricular hemorrhage. Patients with any injury exceeding these are "moderate risk" for progression, and any patient receiving a monitor or craniotomy is "high risk." From February 2010 to November 2012, TBI patients were entered into a dedicated database tracking injury types and sizes, risk category at presentation, and progression on subsequent computed tomgraphies (CTs). The cohort (n=414) was classified as low risk (n=200), moderate risk (n=75), or high risk (n=139) after first CT. After repeat CT scan, radiographic progression was noted in 27% of low-risk, 53% of moderate-risk, and 58% of high-risk subjects. Omnibus analysis of variance test for differences in progression rates was highly significant (p<0.0001). Tukey's post-hoc test showed the low-risk progression rate to be significantly different than both the moderate- and high-risk arms; no difference was noted between the moderate- and high-risk arms themselves. These criteria are a valid tool for classifying TBI patients into two categories of risk for spontaneous progression. This supports tailored chemoprophylaxis regimens for each arm.
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