TOPTBI
Timing Of venous thromboembolism Prophylaxis for adult patients with Traumatic Brain Injury (TOPTBl): a pragmatic, randomised trial
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About TOPTBI
What is TOPTBI?
TOPTBI is a multi-centre, parallel-group, pragmatic, randomised superiority trial to determine the clinical- and cost-effectiveness of early pharmacological thromboprophylaxis (PTP) administration versus late administration for adult patients with TBI.
TOP TBI
Background
01.
Fever
Traumatic Brain Injury patients are typically given blood thinning medications to reduce the chances of developing blood clots and to improve their long-term function outlook and quality of life. Some doctors start blood thinning medications within 72 hours from injury, but other doctors prefer to delay giving these drugs for 5 days or more or not give them at all as they are worried that the drugs may increase the risk of further bleed in the brain. However, several studies have shown that following TBI, giving blood thinning medication within 72 hours of injury does not increase the risk of further bleeding.
This study is designed to compare the timing of giving blood thinning medication following TBI and to guide the best practices in the future for starting blood thinning medication in order to reduce the rate of blood clots, without introducing complications from further bleeding. In this trial, we will be comparing the early initiation of blood thinning medications (within 72 hours from injury) to late initiation (deferred by a minimum of 120 hours from injury or not given at all if deemed clinically unnecessary by clinical team).
Trial News
Dear colleagues, Our next NIHR report will be submitted on 10 May 2026, and will include a site-level breakdown of recruitment up to the end of April. This reporting period provides an important opportunity for us to showcase progress across the study. We would especially welcome increased recruitment activity in the coming weeks, with a focus on supporting sites with lower recruitment to demonstrate measurable improvement. Mr Angelos Kolias
We would like to thank all sites for your continued hard work and commitment. Your efforts are instrumental in helping us reach the recruitment targeted for the pilot phase and in laying a strong foundation for the substantive phase. With your dedication and collaboration, we are confident that we will deliver this study to the highest standard. The trial opened to recruitment on 02 June 2025 and 118 patients have been recruited! We need at least 150 participants by December 2025 - so keep up the good work! Mr Angelos Kolias
