PMID- 35430941
OWN - NLM
STAT- MEDLINE
DCOM- 20230726
LR  - 20230726
IS  - 1708-539X (Electronic)
IS  - 1708-5381 (Linking)
VI  - 31
IP  - 4
DP  - 2023 Aug
TI  - Postoperative antiplatelet and/or anticoagulation use does not impact 
      complication or reintervention rates after vein repair of arterial injury: A 
      PROOVIT study.
PG  - 777-783
LID - 10.1177/17085381221082371 [doi]
AB  - INTRODUCTION: The use of antiplatelet (AP) and anticoagulation (AC) therapy after 
      autogenous vein repair of traumatic arterial injury is controversial. The 
      hypothesis in this study was that there is no difference in early postoperative 
      outcomes regardless of whether AC, AP, both, or neither are used. METHODS: The 
      American Association for the Surgery of Trauma (AAST) PROspective Observational 
      Vascular Injury Treatment (PROOVIT) registry was queried from November, 2013, to 
      January, 2019, for arterial injuries repaired with a vein graft. Demographics and 
      injury characteristics were compared. Need for in-hospital reoperation was the 
      primary outcome in this four-arm study, assessed with two ordinal logistic 
      regression models (1. no therapy vs. AC only vs. AC and AP; 2. no therapy vs. AP 
      only vs. AC and AP). RESULTS: 373 patients (52 no therapy, 88 AP only, 77 AC 
      only, 156 both) from 19 centers with recorded Injury Severity Scores (ISS) were 
      identified. Patients who received no therapy were younger than those who received 
      AP (27.0 vs. 34.2, p = 0.02), had higher transfusion requirement (p < 0.01 
      between all groups) and a different distribution of anatomic injury (p < 0.01). 
      After controlling for age, sex, ISS, platelet count, hemoglobin, pH, lactate, 
      INR, transfusion requirement and anatomic location, there was no association with 
      postoperative medical therapy and in-hospital operative reintervention, or any 
      secondary outcome, including thrombosis (p = 0.67, p = 0.22). CONCLUSIONS: 
      Neither AC nor AP alone, nor in combination, impact complication rate after 
      arterial repair with autologous vein. These patients can be safely treated with 
      or without antithrombotics, recognizing that this study did not demonstrate a 
      beneficial effect.
FAU - Stonko, David P
AU  - Stonko DP
AUID- ORCID: 0000-0002-2804-2857
AD  - Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA. RINGGOLD: 
      160877
AD  - University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, MD, USA. 
      RINGGOLD: 137889
FAU - Betzold, Richard D
AU  - Betzold RD
AD  - University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, MD, USA. 
      RINGGOLD: 137889
FAU - Azar, Faris K
AU  - Azar FK
AD  - St Mary's Medical Center, West Palm Beach, Florida Atlantic University, Boca 
      Raton, FL USA.
FAU - Edwards, Joseph
AU  - Edwards J
AD  - University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, MD, USA. 
      RINGGOLD: 137889
FAU - Abdou, Hossam
AU  - Abdou H
AUID- ORCID: 0000-0003-4396-1656
AD  - University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, MD, USA. 
      RINGGOLD: 137889
FAU - Elansary, Noha N
AU  - Elansary NN
AD  - University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, MD, USA. 
      RINGGOLD: 137889
FAU - Gerling, Kimberly A
AU  - Gerling KA
AD  - Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
FAU - White, Joseph
AU  - White J
AD  - Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
FAU - Feliciano, David V
AU  - Feliciano DV
AD  - University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, MD, USA. 
      RINGGOLD: 137889
FAU - DuBose, Joseph J
AU  - DuBose JJ
AD  - Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
FAU - Morrison, Jonathan J
AU  - Morrison JJ
AUID- ORCID: 0000-0001-7462-8456
AD  - University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, MD, USA. 
      RINGGOLD: 137889
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220416
PL  - England
TA  - Vascular
JT  - Vascular
JID - 101196722
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Humans
MH  - *Vascular System Injuries/surgery
MH  - Vascular Surgical Procedures
MH  - Arteries/surgery
MH  - Prospective Studies
MH  - Anticoagulants
MH  - Treatment Outcome
MH  - Retrospective Studies
OTO - NOTNLM
OT  - PROOVIT
OT  - anticoagulation
OT  - antiplatelet
OT  - arterial injury
OT  - trauma outcomes
OT  - vascular repair
OT  - vascular trauma
OT  - vein interposition
EDAT- 2022/04/19 06:00
MHDA- 2023/07/26 06:43
CRDT- 2022/04/18 05:32
PHST- 2023/07/26 06:43 [medline]
PHST- 2022/04/19 06:00 [pubmed]
PHST- 2022/04/18 05:32 [entrez]
AID - 10.1177/17085381221082371 [doi]
PST - ppublish
SO  - Vascular. 2023 Aug;31(4):777-783. doi: 10.1177/17085381221082371. Epub 2022 Apr 
      16.