TY - JOUR
T1 - Early thromboembolic prophylaxis in patients with blunt solid abdominal organ injuries undergoing nonoperative management
T2 - Is it safe?
AU - Joseph, Bellal
AU - Pandit, Viraj
AU - Harrison, Caitlyn
AU - Lubin, Dafney
AU - Kulvatunyou, Narong
AU - Zangbar, Bardiya
AU - Tang, Andrew
AU - OKeeffe, Terence
AU - Green, Donald J.
AU - Gries, Lynn
AU - Friese, Randall S.
AU - Rhee, Peter
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background The aim of this study was to compare the safety of early (≥48 hours), intermediate (48 to 72 hours), and late (≥72 hours) venous thromboembolism prophylaxis in patients with blunt abdominal solid organ injury managed nonoperatively.Methods We performed a 6-year (2006 to 2011) retrospective review of all trauma patients with blunt abdominal solid organ injuries. Patients were matched using propensity score matching in a 2:1:1 (early:intermediate:late) for age, gender, systolic blood pressure, Glasgow Coma Scale, Injury Severity Score, and type and grade of organs injured. Our primary outcome measures were: hemorrhage complications and need for intervention (operative intervention and/or angioembolization).Results A total of 116 patients (58 early, 29 intermediate, and 29 late) were included. There were no differences in age (P =.5), Injury Severity Score (P =.6), type (P =.1), and grade of injury of the organ (P =.6) between the 3 groups. There were 67 liver (43.2%), 63 spleen (40.6%), 49 kidney (31.6%), and 24 multiple solid organ (15.4%) injuries. There was no difference in operative intervention (P =.8) and postprophylaxis blood transfusion (P =.3) between the 3 groups.Conclusions Early enoxaparin-based anticoagulation may be a safe option in trauma patients with blunt solid organ injury. This study showed no significant correlation between early anticoagulation and development of bleeding complications.
AB - Background The aim of this study was to compare the safety of early (≥48 hours), intermediate (48 to 72 hours), and late (≥72 hours) venous thromboembolism prophylaxis in patients with blunt abdominal solid organ injury managed nonoperatively.Methods We performed a 6-year (2006 to 2011) retrospective review of all trauma patients with blunt abdominal solid organ injuries. Patients were matched using propensity score matching in a 2:1:1 (early:intermediate:late) for age, gender, systolic blood pressure, Glasgow Coma Scale, Injury Severity Score, and type and grade of organs injured. Our primary outcome measures were: hemorrhage complications and need for intervention (operative intervention and/or angioembolization).Results A total of 116 patients (58 early, 29 intermediate, and 29 late) were included. There were no differences in age (P =.5), Injury Severity Score (P =.6), type (P =.1), and grade of injury of the organ (P =.6) between the 3 groups. There were 67 liver (43.2%), 63 spleen (40.6%), 49 kidney (31.6%), and 24 multiple solid organ (15.4%) injuries. There was no difference in operative intervention (P =.8) and postprophylaxis blood transfusion (P =.3) between the 3 groups.Conclusions Early enoxaparin-based anticoagulation may be a safe option in trauma patients with blunt solid organ injury. This study showed no significant correlation between early anticoagulation and development of bleeding complications.
KW - Bleeding complications
KW - Blunt solid organ injury
KW - Failure of nonoperative management
KW - Timing of venous thromboembolism prophylaxis
KW - Venous thromboembolism prophylaxis
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U2 - 10.1016/j.amjsurg.2014.03.007
DO - 10.1016/j.amjsurg.2014.03.007
M3 - Article
C2 - 24928334
AN - SCOPUS:84916242668
VL - 209
SP - 194
EP - 198
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 1
ER -