PMID- 32921671
OWN - NLM
STAT- MEDLINE
DCOM- 20201013
LR  - 20201013
IS  - 1349-3299 (Electronic)
IS  - 1349-2365 (Linking)
VI  - 61
IP  - 5
DP  - 2020 Sep 29
TI  - How to Safely Prevent Venous Thromboembolism in Severe Trauma Patients.
PG  - 993-998
LID - 10.1536/ihj.20-153 [doi]
AB  - Venous thromboembolism (VTE) is a life-threatening complication after trauma. 
      Several studies have reported VTE prophylaxis using low-molecular-weight heparin; 
      however, there is no consensus for prophylaxis after trauma. This study aimed to 
      assess the efficacy and safety of our new anticoagulation therapy protocol using 
      unfractionated heparin (UFH) plus intermittent pneumatic compression (IPC) to 
      prevent post-traumatic VTE in high-risk trauma patients.This study enrolled 70 
      trauma patients who were admitted to the emergency medical center of Nagasaki 
      University Hospital and had Risk Assessment Profile (RAP) scores >/= 5. After 
      stopping bleeding at the trauma site, all patients received intravenous UFH 
      (10,000 U/day) plus IPC, which was continued for 14 days or until the patients 
      could walk. On days 7 and 14, all patients underwent lower extremity sonography 
      for deep-vein thrombosis screening. VTE incidences between patients with the 
      above intervention and historical controls with IPC alone were compared.No 
      significant differences in age, sex, and the RAP score were observed between the 
      105 controls and intervention patients. VTE occurrence was fewer in patients with 
      the intervention (14.3%) than in the controls (28.6%; P = 0.029). No hemorrhagic 
      complications occurred after UFH administration. Multivariable logistic analysis 
      revealed a significant association between the intervention and low incidence of 
      VTE (odds ratio: 0.390; 95% confidence interval: 0.163-0.913; P = 0.030).Routine 
      UFH administration with IPC may prevent post-traumatic VTE without adverse 
      events.
FAU - Iyama, Keita
AU  - Iyama K
AD  - Department of Radiation Disaster Medicine, Fukushima Medical University.
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
AD  - Department of Emergency Medicine, Nagasaki University Graduate School of 
      Biomedical Sciences.
FAU - Ikeda, Satoshi
AU  - Ikeda S
AD  - Department of Cardiovascular Medicine, Nagasaki University Graduate School of 
      Biomedical Sciences.
FAU - Inokuma, Takamitsu
AU  - Inokuma T
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
FAU - Sato, Shuntaro
AU  - Sato S
AD  - Clinical Research Center, Nagasaki University Hospital.
FAU - Yamano, Shuhei
AU  - Yamano S
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
FAU - Tajima, Goro
AU  - Tajima G
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
FAU - Hirao, Tomohito
AU  - Hirao T
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
FAU - Nozaki, Yoshihiro
AU  - Nozaki Y
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
FAU - Yamashita, Kazunori
AU  - Yamashita K
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
FAU - Kawano, Hiroaki
AU  - Kawano H
AD  - Department of Cardiovascular Medicine, Nagasaki University Graduate School of 
      Biomedical Sciences.
FAU - Maemura, Koji
AU  - Maemura K
AD  - Department of Cardiovascular Medicine, Nagasaki University Graduate School of 
      Biomedical Sciences.
FAU - Tasaki, Osamu
AU  - Tasaki O
AD  - Acute and Critical Care Center, Nagasaki University Hospital.
AD  - Department of Emergency Medicine, Nagasaki University Graduate School of 
      Biomedical Sciences.
LA  - eng
PT  - Journal Article
DEP - 20200912
PL  - Japan
TA  - Int Heart J
JT  - International heart journal
JID - 101244240
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrin Fibrinogen Degradation Products)
RN  - 0 (fibrin fragment D)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Cohort Studies
MH  - Female
MH  - Fibrin Fibrinogen Degradation Products/metabolism
MH  - Heparin/*therapeutic use
MH  - Hospitalization
MH  - Humans
MH  - Injury Severity Score
MH  - *Intermittent Pneumatic Compression Devices
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Partial Thromboplastin Time
MH  - Pulmonary Embolism/*prevention & control
MH  - Risk Assessment
MH  - Thrombophilia/blood
MH  - Venous Thromboembolism/*prevention & control
MH  - Venous Thrombosis/*prevention & control
MH  - Wounds and Injuries/blood/*therapy
OTO - NOTNLM
OT  - Deep-vein thrombosis
OT  - Preventable trauma death
OT  - Prevention
OT  - Pulmonary embolism
OT  - Unfractionated heparin
EDAT- 2020/09/15 06:00
MHDA- 2020/10/21 06:00
CRDT- 2020/09/14 05:47
PHST- 2020/09/15 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2020/09/14 05:47 [entrez]
AID - 10.1536/ihj.20-153 [doi]
PST - ppublish
SO  - Int Heart J. 2020 Sep 29;61(5):993-998. doi: 10.1536/ihj.20-153. Epub 2020 Sep 
      12.