Early vs. Late Initiation of VTE Prophylaxis in Major Trauma

Clinical Takeaway

: In a young adult population, pharmacologic prophylaxis initiated within 24 hours was associated with lower incidence of venous thromboembolic events without increasing bleeding.

Context

Venous thromboembolism (VTE) risk is high following major trauma, yet clinicians often delay initiating pharmacologic prophylaxis due to concerns about bleeding. Researchers have now performed a multicenter, prospective, observational study of more than 6500 adults hospitalized for trauma (age range, 18–40) comparing early (≤24 hours) versus late (>24 hours) initiation of pharmacologic VTE prophylaxis. Patients had at least one posttraumatic VTE risk factor (e.g., major head, chest, or abdominal injury; spinal cord injury; pelvic or long bone fracture) and a hospital stay >48 hours. The study excluded those with a history of VTE or currently receiving anticoagulation.

Key Results

Overall, 5% of patients developed VTE — significantly mo…

Reviewing Author

Neil H. Winawer, MD, SFHM

Disclosures

Nothing to disclose