DVT Case Studies

Decent Essays
The incidence of DVT & PE is continuously increasing in hospitalized patients especially those admitted after trauma. Major trauma leads to a state of hyper-coagulation by augmenting the components of Virchow’s triad. Acute injury to spine increases this risk of VTE even further. Without thromboprophylaxis, the reported incidence of DVT in these patients ranges from 50-80% and PE is the 3rd most common cause of death with an incidence of 5%[11, 12, 22]. The mechanism underlying increased rates of VTE is multifactorial and it involves immobility and venous stasis secondary to hospitalization, direct endothelial injury, upregulation of coagulation cascade, release of tissue factor and depletion of endogenous anticoagulants secondary to…show more content…
However, the optimal timing of starting thromborprophylaxis in patients with spine trauma managed operatively is unknown and is often challenging due to the balance against bleeding complications. In this study we sought to find the differences in incidence of VTE among patients receiving early thromboprophylaxis compared to late thromboprophylaxis. We performed propensity scoring and both cohorts were matched for all possible patient characteristics which might have confounded our results including demographics (age, race, sex), injury parameters (mechanism, ISS, h-AIS, S-AIS), ED vitals (SBP, HR, GCS), level of spine injured, number of vertebral fractures, operative intervention and type of thromoprophylaxis agent use in order to have two similar cohorts between which outcomes of interest can be compared without any confounding bias. Our study demonstrated that early initiation of thromborprophylaxis was associated with decreased rate of DVT. However, it did not affect the rates of PE. Similar to our results, Jehan et al. also reported a decrease in the incidence of a DVT in the early group (<48 hours of injury) [23]. Moreover, they reported no difference in the incidence of a
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