Retrospective Analysis of LMWH and UFH in Pediatric Trauma Patients: A Comparative Analysis

Michael Hunter Culbert, Mohammad Hamidi, Muhammad Zeeshan, Kamil Hanna, Andrew Romero, Bellal Joseph, Terence O'Keeffe

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Chemoprophylaxis with either unfractionated heparin (UFH) or Low-Molecular-Weight Heparin (LMWH) are recommended to prevent Venous Thromboembolism (VTE) after trauma. Experimental work has shown beneficial effects of LMWH in animal models, but it is unknown if similar effects exist in humans. We hypothesized that treatment with LMWH is associated with a survival benefit when compared to UFH. Methods: We performed a retrospective analysis of our level I trauma center database from January 2009 to June 2018. Pediatric patients (age < 18) were included if they received either LMWH or UFH during their stay. Outcome measures included mortality, VTE complications, and hospital length of stay (HLOS). Results: A total of 354 patients were included. Patients who received LMWH had lower mortality compared to those who received UFH. After multivariate logistic regression, LMWH was still independently associated with improved survival. No association was found between LMWH and UFH regarding deep vein thrombosis (DVT) or pulmonary embolism (PE) rates. No association was found between LMWH with HLOS. Conclusions: LMWH was associated with improved survival compared to UFH in our pediatric trauma patients. This was independent of injury severity or VTE complications. Further studies are required to understand better the mechanisms by which LMWH improves survival. Level of Evidence: 3.

Original languageEnglish (US)
Pages (from-to)121-129
Number of pages9
JournalJournal of Surgical Research
Volume249
DOIs
StatePublished - May 2020
Externally publishedYes

Keywords

  • Low molecular weight heparin
  • Mortality
  • Pediatrics
  • Trauma
  • VTE prophylaxis

ASJC Scopus subject areas

  • Surgery

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