PRaCTUS BCVI: Pragmatic Randomized Clinical Trial of Universal Screening for BCVI
PRaCTUS BCVI is a pragmatic stepped-wedge cluster-randomized trial comparing universal screening with selective screening for blunt cerebrovascular injury (BCVI) in adult patients with major blunt trauma. The feasibility study will include five Level 1 or Level 2 trauma centers currently using selective screening, with centers crossing over to universal screening at randomized two-month intervals. The primary outcome is BCVI-related ischemic stroke, with additional outcomes including stroke-related death, antithrombotic-related bleeding, acute kidney injury, BCVI detection rate and grade distribution, and CTA utilization. The 12-month feasibility study will assess whether the study design, outcome definitions, data collection, and event rates can support a future large-scale trial anticipated to include at least 20 trauma centers.