Retrospective Analysis of Low-Molecular-Weight Heparin and Unfractionated Heparin in Pediatric Trauma Patients: A Comparative Analysis
AuthorCulbert, Michael Hunter
AffiliationUniv Arizona, Coll Med, Dept Surg
MetadataShow full item record
PublisherACADEMIC PRESS INC ELSEVIER SCIENCE
CitationCulbert, M. H., Hamidi, M., Zeeshan, M., Hanna, K., Romero, A., Joseph, B., & O'Keeffe, T. (2020). Retrospective Analysis of LMWH and UFH in Pediatric Trauma Patients: A Comparative Analysis. Journal of Surgical Research, 249, 121-129. https://doi.org/10.1016/j.jss.2019.11.019
JournalJOURNAL OF SURGICAL RESEARCH
RightsCopyright © 2019 Elsevier Inc. All rights reserved.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractBackground: 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. (C) 2019 Elsevier Inc. All rights reserved.
Note12 month embargo; published online: 10 January 2020
VersionFinal accepted manuscript
- Unfractionated heparin versus low-molecular-weight heparin for venous thromboembolism prophylaxis in trauma.
- Authors: Jacobs BN, Cain-Nielsen AH, Jakubus JL, Mikhail JN, Fath JJ, Regenbogen SE, Hemmila MR
- Issue date: 2017 Jul
- Determining the impact of culture on venous thromboembolism prevention in trauma patients: A Southwestern Surgical Congress Multicenter trial.
- Authors: Regner JL, Shaver CN, SWSC Multicenter Trials Group.
- Issue date: 2019 Jun
- Evaluation of unfractionated heparin versus low-molecular-weight heparin and fondaparinux for pharmacologic venous thromboembolic prophylaxis in critically ill patients with cancer.
- Authors: Van Matre ET, Reynolds PM, MacLaren R, Mueller SW, Wright GC, Moss M, Burnham EL, Ho PM, Vandivier RW, Kiser TH
- Issue date: 2018 Dec
- Is low-molecular-weight heparin safe for venous thromboembolism prophylaxis in patients with traumatic brain injury? A Western Trauma Association multicenter study.
- Authors: Kwiatt ME, Patel MS, Ross SE, Lachant MT, MacNew HG, Ochsner MG, Norwood SH, Speier L, Kozar R, Gerber JA, Rowell S, Krishnakumar S, Livingston DH, Manis G, Haan JM
- Issue date: 2012 Sep
- Meta-analysis of venous thromboembolism prophylaxis in medically Ill patients.
- Authors: Kanaan AO, Silva MA, Donovan JL, Roy T, Al-Homsi AS
- Issue date: 2007 Nov