Belcher RM, Kay AB, Fontaine GV, Baldwin M, Bledsoe JR, Collingridge DS, Majercik S. Post-discharge venous thromboembolism prophylaxis in hospitalized trauma patients: A retrospective comparison of patients receiving versus not receiving post-discharge prophylaxis.
Am J Surg 2024;
228:247-251. [PMID:
37863796 DOI:
10.1016/j.amjsurg.2023.10.032]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND
Risk of venous thromboembolism (VTE) in many trauma patients extends beyond hospitalization, but there is a paucity of evidence to guide the use of post-discharge prophylaxis (PDP).
METHODS
A retrospective cohort study of trauma patients deemed moderate-to-high risk for VTE (risk assessment profile score [RAP] ≥5) who were prescribed PDP based on an internal clinical guideline assessing injury pattern and mobility status. PDP patients were compared with those that did not receive post-discharge prophylaxis (NPDP).
RESULTS
1512 patients were included. PDP group had higher mean RAP score (7.3 vs. 6.4, p < 0.001), more likely to have a complex orthopedic fracture and underwent a longer median hospital (4.7 vs. 2.9 days, p < 0.001). No difference between groups in 90-day VTE (11 [1.5 %] (PDP) vs. 8 [1.0 %] (NPDP), p = 0.50), clinically relevant bleeding (p = 0.58), or readmission (p = 0.46).
CONCLUSIONS
VTE incidence, clinically relevant bleeding, and readmission 90-days after hospital discharge were low and similar between PDP and NPDP groups. PDP prescribed in a presumably higher VTE risk trauma population may mitigate the long-term risk of VTE.
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