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Titolo:
A potentially expanded role for enoxaparin in preventing venous thromboembolism in high risk blunt trauma patients
Autore:
Norwood, SH; McAuley, CE; Berne, JD; Vallina, VL; Kerns, DB; Grahm, TW; McLarty, JW;
Indirizzi:
E Texas Med Ctr, Trauma Serv, Tyler, TX USA E Texas Med Ctr Tyler TX USAE Texas Med Ctr, Trauma Serv, Tyler, TX USA E Texas Med Ctr, Neurosurg Serv, Tyler, TX USA E Texas Med Ctr Tyler TX USA exas Med Ctr, Neurosurg Serv, Tyler, TX USA Univ Texas, Ctr Hlth, Tyler, TX USA Univ Texas Tyler TX USAUniv Texas, Ctr Hlth, Tyler, TX USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
fascicolo: 2, volume: 192, anno: 2001,
pagine: 161 - 167
SICI:
1072-7515(200102)192:2<161:APERFE>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
MOLECULAR-WEIGHT HEPARIN; CAVA FILTER INSERTION; LOW-DOSE HEPARIN; PULMONARY-EMBOLISM; MAJOR TRAUMA; COMPRESSION STOCKINGS; PROPHYLAXIS; THROMBOSIS; NEUROSURGERY; PLACEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Norwood, SH 1020 E Idel St, Tyler, TX 75701 USA 1020 E Idel St Tyler TX USA 75701 del St, Tyler, TX 75701 USA
Citazione:
S.H. Norwood et al., "A potentially expanded role for enoxaparin in preventing venous thromboembolism in high risk blunt trauma patients", J AM COLL S, 192(2), 2001, pp. 161-167

Abstract

BACKGROUND: Venous thromboembolism (VTE) is a frequent and potentially life-threatening complication after trauma. The purpose of this study is to investigate the effectiveness of enoxaparin in preventing deep venous thrombosis (DVT) and pulmonary embolism (PE) after injury in patients who are at high risk for developing VTE. STUDY DESIGN: A prospective single-cohort observational study was initiated for seriously injured blunt trauma patients admitted to a Level I trauma center during a 7-month period. Patients were eligible for the study if time hospitalized was greater than or equal to 72 hours, Injury Severity Score(ISS) was greater than or equal to 9, enoxaparin was started within 24 hours after admission, and one or more of the following high risk criteria were met: age > 50 years, ISS greater than or equal to 16, presence of a femoral vein catheter, Abbreviated Injury Score (AIS) greater than or equal to 3for any body region, Glasgow Coma Scale (GCS) Score less than or equal to 8, presence of major pelvic, femur, or tibia fracture, and presence of direct blunt mechanism venous injury. Patients with closed head injuries and nonoperatively treated solid abdominal organ injuries were also potential participants. The primary outcomes measured were thromboembolic events-either a documented lower extremity DVT by duplex color-flow doppler ultrasonography or a PE documented by rapid infusion CT pulmonary angiography or conventional pulmonary angiography. RESULTS: There were 118 patients enrolled in the study. Two patients (2%) developed DVT, one of which was proximal to the calf (95% confidence interval, 0% to 6%). Two of 12 patients (17%) with splenic injuries who received enoxaparin failed initial nonoperative management. There were no other bleeding complications, and no clinical evidence or documented episodes of PE. One patient died from multiple system organ failure. CONCLUSIONS: Enoxaparin is a practical and effective method for reducing the incidence of VTE in high risk, seriously injured patients. This study supports further investigation into the safety of enoxaparin prophylaxis in patients with closed head injuries and nonoperatively treated solid abdominal organ injuries. (J Am Coll Surg 2001;192:161-167. (C) 2001 by the American College of Surgeons).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/06/20 alle ore 14:07:34