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    Retrospective Analysis of Low-Molecular-Weight Heparin and Unfractionated Heparin in Pediatric Trauma Patients: A Comparative Analysis

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    Manuscript_(FINAL_REVISED).pdf
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    Author
    Culbert, Michael Hunter
    Hamidi, Mohammad
    Zeeshan, Muhammad
    Hanna, Kamil
    Romero, Andrew
    Joseph, Bellal
    O'Keeffe, Terence
    Affiliation
    Univ Arizona, Coll Med, Dept Surg
    Issue Date
    2020-05
    Keywords
    low molecular weight heparin
    Mortality
    pediatrics
    Trauma
    VTE prophylaxis
    
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    Publisher
    ACADEMIC PRESS INC ELSEVIER SCIENCE
    Citation
    Culbert, 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
    Journal
    JOURNAL OF SURGICAL RESEARCH
    Rights
    Copyright © 2019 Elsevier Inc. All rights reserved.
    Collection Information
    This 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 repository@u.library.arizona.edu.
    Abstract
    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. (C) 2019 Elsevier Inc. All rights reserved.
    Note
    12 month embargo; published online: 10 January 2020
    ISSN
    0022-4804
    EISSN
    1095-8673
    PubMed ID
    31931398
    DOI
    10.1016/j.jss.2019.11.019
    Version
    Final accepted manuscript
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jss.2019.11.019
    Scopus Count
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    UA Faculty Publications

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