Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparin
Background/objective: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE) and poses a risk to patients with trauma. This study compared the efficacy of direct thrombin inhibitors (DTIs) and low-molecular-weight heparin (LMWH) for the prophylaxis of VTE in pat...
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| Format: | Article |
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Elsevier
2025-05-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958425007043 |
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| author | Jen-Fu Huang Chih-Po Hsu Sheng-Yu Chan Ya-Chiao Lin Chi-Tung Cheng Po-Cheng Lo Meng-Hsuan Lee Wen-Ching Weng Yi-Jung Chen Hsi-Hsin Li Ken-Hsiung Chen Shih-Tien Wang Tsann-Long Hwang |
| author_facet | Jen-Fu Huang Chih-Po Hsu Sheng-Yu Chan Ya-Chiao Lin Chi-Tung Cheng Po-Cheng Lo Meng-Hsuan Lee Wen-Ching Weng Yi-Jung Chen Hsi-Hsin Li Ken-Hsiung Chen Shih-Tien Wang Tsann-Long Hwang |
| author_sort | Jen-Fu Huang |
| collection | DOAJ |
| description | Background/objective: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE) and poses a risk to patients with trauma. This study compared the efficacy of direct thrombin inhibitors (DTIs) and low-molecular-weight heparin (LMWH) for the prophylaxis of VTE in patients with blunt injuries. Methods: This study analyzed data from the American College of Surgeons Trauma Quality Improvement Program, focusing on patients with an injury severity score (ISS) of ≥10 who received VTE prophylaxis. It identified covariates associated with VTE and adverse events. Results: Among 194,154 patients, those on DTIs (n = 205) were older and had higher ISS than those on LMWH (n = 193,949). The DTI group had higher rates of DVT (4.9 % vs 1.3 %), PE (3.4 % vs 0.7 %), unplanned visiting to the operating room (OR) (5.4 % vs 1.5 %), and mortality (8.8 % vs 2.5 %). After propensity score matching, DTIs were associated with increased incidences of DVT (4.9 % vs 1.8 %), PE (3.4 % vs 0.8 %), and unplanned visiting to the OR (5.4 % vs 1.5 %). Multivariate analysis indicated that DTIs significantly increased the odds of DVT (odds ratio, 2.945), PE (odds ratio, 4.250), and unplanned visiting to the OR (odds ratio, 4.175). Conclusion: DTIs are linked to more DVT and PE than LMWH in VTE prevention. LMWH is more effective than the other options and causes fewer adverse events. LMWH is preferred for patients with blunt injuries and an ISS of ≥10. |
| format | Article |
| id | doaj-art-da54022bb8d74efab4576950d143280c |
| institution | Kabale University |
| issn | 1015-9584 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj-art-da54022bb8d74efab4576950d143280c2025-08-20T03:52:38ZengElsevierAsian Journal of Surgery1015-95842025-05-014852874288110.1016/j.asjsur.2025.03.123Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparinJen-Fu Huang0Chih-Po Hsu1Sheng-Yu Chan2Ya-Chiao Lin3Chi-Tung Cheng4Po-Cheng Lo5Meng-Hsuan Lee6Wen-Ching Weng7Yi-Jung Chen8Hsi-Hsin Li9Ken-Hsiung Chen10Shih-Tien Wang11Tsann-Long Hwang12Division of Trauma and Emergency Surgery, Department of General Surgery, Jen-Ai Hospital, Dali Branch, Taichung, Taiwan; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University, Taoyuan, TaiwanDepartment of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University, Taoyuan, TaiwanDepartment of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University, Taoyuan, TaiwanKinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanDepartment of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University, Taoyuan, TaiwanKinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanKinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanKinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanKinmen Hospital, Ministry of Health and Welfare, Kinmen, Taiwan; Corresponding author. Kinmen Hospital, Ministry of Health and Welfare, No. 2, Fuxing Road, Jinhu Township, Kinmen County, 891, Taiwan.Kinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanKinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanKinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanChang Gung University, Taoyuan, Taiwan; Department of General Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanBackground/objective: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE) and poses a risk to patients with trauma. This study compared the efficacy of direct thrombin inhibitors (DTIs) and low-molecular-weight heparin (LMWH) for the prophylaxis of VTE in patients with blunt injuries. Methods: This study analyzed data from the American College of Surgeons Trauma Quality Improvement Program, focusing on patients with an injury severity score (ISS) of ≥10 who received VTE prophylaxis. It identified covariates associated with VTE and adverse events. Results: Among 194,154 patients, those on DTIs (n = 205) were older and had higher ISS than those on LMWH (n = 193,949). The DTI group had higher rates of DVT (4.9 % vs 1.3 %), PE (3.4 % vs 0.7 %), unplanned visiting to the operating room (OR) (5.4 % vs 1.5 %), and mortality (8.8 % vs 2.5 %). After propensity score matching, DTIs were associated with increased incidences of DVT (4.9 % vs 1.8 %), PE (3.4 % vs 0.8 %), and unplanned visiting to the OR (5.4 % vs 1.5 %). Multivariate analysis indicated that DTIs significantly increased the odds of DVT (odds ratio, 2.945), PE (odds ratio, 4.250), and unplanned visiting to the OR (odds ratio, 4.175). Conclusion: DTIs are linked to more DVT and PE than LMWH in VTE prevention. LMWH is more effective than the other options and causes fewer adverse events. LMWH is preferred for patients with blunt injuries and an ISS of ≥10.http://www.sciencedirect.com/science/article/pii/S1015958425007043Direct thrombin inhibitorsLow-molecular-weight heparinVenous thromboembolism |
| spellingShingle | Jen-Fu Huang Chih-Po Hsu Sheng-Yu Chan Ya-Chiao Lin Chi-Tung Cheng Po-Cheng Lo Meng-Hsuan Lee Wen-Ching Weng Yi-Jung Chen Hsi-Hsin Li Ken-Hsiung Chen Shih-Tien Wang Tsann-Long Hwang Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparin Asian Journal of Surgery Direct thrombin inhibitors Low-molecular-weight heparin Venous thromboembolism |
| title | Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparin |
| title_full | Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparin |
| title_fullStr | Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparin |
| title_full_unstemmed | Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparin |
| title_short | Comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma: Direct thrombin inhibitors vs low-molecular-weight heparin |
| title_sort | comparative efficacy of venous thromboembolism prophylaxis in patients with blunt trauma direct thrombin inhibitors vs low molecular weight heparin |
| topic | Direct thrombin inhibitors Low-molecular-weight heparin Venous thromboembolism |
| url | http://www.sciencedirect.com/science/article/pii/S1015958425007043 |
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