Clinical ScienceEarly thromboembolic prophylaxis in patients with blunt solid abdominal organ injuries undergoing nonoperative management: is it safe?
Section snippets
Methods
After the approval from the Institutional Review Board of the University of Arizona, College of Medicine, we performed a 6-year (2006 to 2011) retrospective review of all trauma patients with blunt solid organ injuries who presented to our Level-1 trauma center. Patients with blunt solid organ injuries who underwent NOM and received VTE prophylaxis during their hospitalization were included. Patients transferred from other facilities and patients with isolated head injury (head Abbreviated
Results
A total of 852 patients with blunt solid organ injuries that were managed nonoperatively were reviewed. Of which, 274 patients met inclusion criteria. After matching, a total of 116 patients (58 early, 29 intermediate, and 29 late) were included in the analysis. The mean age was 42.2 ± 20.3 years, 66.4% were males, mean SBP was 130.5 ± 26.5 mm Hg, and median ISS was 17 (12 to 22). There were no differences in age (P = .5), SBP (P = .8), INR on presentation (P = .5), and injury severity (P = .6)
Comments
The fears of development of hemorrhagic complications and failure of NOM limit the early initiation of thromboembolic prophylaxis in patients with blunt solid organ injury.3, 8, 9 This study demonstrates that early enoxaparin-based anticoagulation may be safe in patients with blunt solid organ injury. In our matched cohort of patients, we found no difference in development of hemorrhagic complications and the rate of intervention between patients receiving early, intermediate, or late VTE
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. Future prospective studies are required to define the impact of early VTE prophylaxis in the trauma patients.
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The authors have no financial or proprietary interest in the subject matter or materials discussed in the article.
The authors declare no conflicts of interest.