PMID- 31931398
OWN - NLM
STAT- MEDLINE
DCOM- 20200731
LR  - 20200731
IS  - 1095-8673 (Electronic)
IS  - 0022-4804 (Linking)
VI  - 249
DP  - 2020 May
TI  - Retrospective Analysis of Low-Molecular-Weight Heparin and Unfractionated Heparin 
      in Pediatric Trauma Patients: A Comparative Analysis.
PG  - 121-129
LID - S0022-4804(19)30813-3 [pii]
LID - 10.1016/j.jss.2019.11.019 [doi]
AB  - BACKGROUND: Chemoprophylaxis with either unfractionated heparin (UFH) or 
      Low-Molecular-Weight Heparin (LMWH) are recommended to prevent Venous 
      Thromboembolism (VTE) after trauma. Experimental work has shown beneficial 
      effects of LMWH in animal models, but it is unknown if similar effects exist in 
      humans. We hypothesized that treatment with LMWH is associated with a survival 
      benefit when compared to UFH. METHODS: We performed a retrospective analysis of 
      our level I trauma center database from January 2009 to June 2018. Pediatric 
      patients (age < 18) were included if they received either LMWH or UFH during 
      their stay. Outcome measures included mortality, VTE complications, and hospital 
      length of stay (HLOS). RESULTS: A total of 354 patients were included. Patients 
      who received LMWH had lower mortality compared to those who received UFH. After 
      multivariate logistic regression, LMWH was still independently associated with 
      improved survival. No association was found between LMWH and UFH regarding deep 
      vein thrombosis (DVT) or pulmonary embolism (PE) rates. No association was found 
      between LMWH with HLOS. CONCLUSIONS: LMWH was associated with improved survival 
      compared to UFH in our pediatric trauma patients. This was independent of injury 
      severity or VTE complications. Further studies are required to understand better 
      the mechanisms by which LMWH improves survival. LEVEL OF EVIDENCE: 3.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Culbert, Michael Hunter
AU  - Culbert MH
AD  - Department of Surgery, University of Arizona College of Medicine, Tucson, 
      Arizona. Electronic address: hunterculbert@surgery.arizona.edu.
FAU - Hamidi, Mohammad
AU  - Hamidi M
AD  - Department of Surgery, University of Arizona College of Medicine, Tucson, 
      Arizona.
FAU - Zeeshan, Muhammad
AU  - Zeeshan M
AD  - Department of Surgery, University of Arizona College of Medicine, Tucson, 
      Arizona.
FAU - Hanna, Kamil
AU  - Hanna K
AD  - Department of Surgery, University of Arizona College of Medicine, Tucson, 
      Arizona.
FAU - Romero, Andrew
AU  - Romero A
AD  - Department of Surgery, University of Arizona College of Medicine, Tucson, 
      Arizona.
FAU - Joseph, Bellal
AU  - Joseph B
AD  - Department of Surgery, University of Arizona College of Medicine, Tucson, 
      Arizona.
FAU - O'Keeffe, Terence
AU  - O'Keeffe T
AD  - Department of Surgery, University of Arizona College of Medicine, Tucson, 
      Arizona.
LA  - eng
PT  - Journal Article
DEP - 20200110
PL  - United States
TA  - J Surg Res
JT  - The Journal of surgical research
JID - 0376340
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Adolescent
MH  - Anticoagulants/*administration & dosage
MH  - Child
MH  - Databases, Factual/statistics & numerical data
MH  - Female
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Injury Severity Score
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Trauma Centers/statistics & numerical data
MH  - Treatment Outcome
MH  - Venous Thromboembolism/etiology/mortality/*prevention & control
MH  - Wounds and Injuries/*complications/diagnosis/mortality
OTO - NOTNLM
OT  - Low molecular weight heparin
OT  - Mortality
OT  - Pediatrics
OT  - Trauma
OT  - VTE prophylaxis
EDAT- 2020/01/14 06:00
MHDA- 2020/08/01 06:00
CRDT- 2020/01/14 06:00
PHST- 2019/06/28 00:00 [received]
PHST- 2019/09/28 00:00 [revised]
PHST- 2019/11/03 00:00 [accepted]
PHST- 2020/01/14 06:00 [pubmed]
PHST- 2020/08/01 06:00 [medline]
PHST- 2020/01/14 06:00 [entrez]
AID - S0022-4804(19)30813-3 [pii]
AID - 10.1016/j.jss.2019.11.019 [doi]
PST - ppublish
SO  - J Surg Res. 2020 May;249:121-129. doi: 10.1016/j.jss.2019.11.019. Epub 2020 Jan 
      10.