Early thromboembolic prophylaxis in patients with blunt solid abdominal organ injuries undergoing nonoperative management: Is it safe?

Bellal Joseph, Viraj Pandit, Caitlyn Harrison, Dafney Lubin, Narong Kulvatunyou, Bardiya Zangbar, Andrew Tang, Terence OKeeffe, Donald J. Green, Lynn Gries, Randall S. Friese, Peter Rhee

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)194-198
Number of pages5
JournalAmerican Journal of Surgery
Volume209
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Keywords

  • Bleeding complications
  • Blunt solid organ injury
  • Failure of nonoperative management
  • Timing of venous thromboembolism prophylaxis
  • Venous thromboembolism prophylaxis

ASJC Scopus subject areas

  • Surgery

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    Joseph, B., Pandit, V., Harrison, C., Lubin, D., Kulvatunyou, N., Zangbar, B., Tang, A., OKeeffe, T., Green, D. J., Gries, L., Friese, R. S., & Rhee, P. (2015). Early thromboembolic prophylaxis in patients with blunt solid abdominal organ injuries undergoing nonoperative management: Is it safe? American Journal of Surgery, 209(1), 194-198. https://doi.org/10.1016/j.amjsurg.2014.03.007