* Restart TICrH: An Adaptive Randomized Trial of Time Intervals to Restart Direct Oral Anticoagulants after Traumatic Intracranial Hemorrhage.
- Anticoagulants prevent thrombosis and death in patients with atrial fibrillation and venous thromboembolism (VTE) but also increase bleeding risk. The benefit/risk ratio favors anticoagulation in most of these patients. However, some will have a bleeding complication, such as the common trip-and-fall brain injury in elderly patients that results in traumatic intracranial hemorrhage. Clinicians must then make the difficult decision about when to restart the anticoagulant. Restarting too early risks making the bleeding worse. Restarting too late risks thrombotic events such as ischemic stroke and VTE, the indications for anticoagulation in the first place. There are more data on restarting patients with spontaneous intracranial hemorrhage, which is very different than traumatic intracranial hemorrhage. Spontaneous intracranial hemorrhage increases the risk of rebleeding because intrinsic vascular changes are widespread and irreversible. In contrast, traumatic cases are caused by a blow to the head, usually an isolated event portending less future risk. Clinicians generally agree that anticoagulation should be restarted but disagree about when. This uncertainty leads to long restart delays causing a large, potentially preventable burden of strokes and VTE, which has been unaddressed because of the absence of high quality evidence. Restart Traumatic Intracranial Hemorrhage (the "r" distinguished intracranial from intracerebral) (TICrH) is a prospective randomized open label blinded end-point response-adaptive clinical trial that will evaluate the impact of delays to restarting direct oral anticoagulation (1, 2, or 4 weeks) on the composite of thrombotic events and bleeding in patients presenting after traumatic intracranial hemorrhage.
=>1.損害の恐れ, 危険, 冒険, リスク, 2.危険にさらす, 3.敢えてする, 被保険者, 被保険物, 危険にさらす,
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Overview of noun risk
The noun risk has 4 senses (first 2 from tagged texts)
1. (4) hazard, jeopardy, peril, risk, endangerment -- (a source of danger; a possibility of
incurring loss or misfortune; "drinking alcohol is a health hazard")
2. (2) risk, peril, danger -- (a venture undertaken without regard to possible loss or injury; "he
saw the rewards but not the risks of crime"; "there was a danger he would do the wrong thing")
3. risk, risk of infection -- (the probability of becoming infected given that exposure to an
infectious agent has occurred)
4. risk, risk of exposure -- (the probability of being exposed to an infectious agent)
Overview of verb risk
The verb risk has 2 senses (first 2 from tagged texts)
1. (8) risk, put on the line, lay on the line -- (expose to a chance of loss or damage; "We risked
losing a lot of money in this venture"; "Why risk your life?"; "She laid her job on the line when
she told the boss that he was wrong")
2. (2) gamble, chance, risk, hazard, take chances, adventure, run a risk, take a chance -- (take a
risk in the hope of a favorable outcome; "When you buy these stocks you are gambling")
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