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首页> 外文期刊>The American Journal of Surgery >A retrospective analysis of the effectiveness of low molecular weight heparin for venous thromboembolism prophylaxis in trauma patients
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A retrospective analysis of the effectiveness of low molecular weight heparin for venous thromboembolism prophylaxis in trauma patients

机译：回顾性分析低分子量肝素对预防创伤患者静脉血栓栓塞的有效性

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Background: In trauma patients, Enoxaparin (a low molecular weight heparin, LMWH) prophylaxis for venous thromboembolism (VTE) risk reduction is unproven. Methods: Cohort analysis conducted consisting of all trauma patients age >13 admitted to Level-I trauma center and hospitalized >48 hours. VTE risk determined by the Risk Assessment Profile. High risk patients received LMWH unless contraindicated, while low and moderate risk patients received LMWH at attending surgeon's discretion. Odds ratio for VTE by logistic regression. VTE incidence, relative risk (RR), and number needed to treat (NNT) to prevent deep vein thrombosis (DVT) or pulmonary embolism determined by risk category. Results: Cohort consisted of 2,281 patients (1,211 low, 979 moderate, 91 high risks). VTE occured in 254 patients (11.1%). High-risk patients had significantly higher VTE incidence, odds ratio = 31.8 (P <.001). VTE was significantly reduced in high-risk patients receiving LMWH versus those who did not (.26 vs.53, P =.02). Among moderate and high risk, prophylactic LMWH reduced the incidence of pulmonary embolism (RR =.19, NNT = 40.4, P =.01), and trended toward reduced DVT incidence (RR =.81, NNT = 27.3, P =.15). LMWH lowered DVT incidence (RR =.52, NNT = 4.1, P =.03) in high risk patients. Conclusion: Prophylactic LMWH is associated with reduction of VTE in trauma patients.
机译：背景：在创伤患者中，依诺肝素（一种低分子量肝素，LMWH）在预防静脉血栓栓塞（VTE）风险方面的预防作用尚未得到证实。方法：队列分析由所有年龄大于13岁，进入I级创伤中心并住院> 48小时的创伤患者组成。 VTE风险由风险评估资料确定。除非有禁忌症，高风险患者接受LMWH，而中低风险患者则应在外科医生的酌情决定下接受LMWH。通过逻辑回归分析得出VTE的赔率。 VTE发生率，相对风险（RR）和预防深静脉血栓形成（DVT）或肺栓塞所需治疗的数量（NNT）（由风险类别决定）。结果：队列包括2,281例患者（1,211低，979中度，91高危）。 VTE发生在254名患者中（11.1％）。高危患者的VTE发生率明显更高，优势比= 31.8（P <.001）。与未接受LMWH的高危患者相比，未接受LMWH的高危患者的VTE显着降低（.26 vs.53，P = .02）。在中度和高危人群中，预防性LMWH降低了肺栓塞的发生率（RR = .19，NNT = 40.4，P = .01），并有降低DVT发生率的趋势（RR = .81，NNT = 27.3，P = .15） ）。在高危患者中，LMWH降低了DVT发生率（RR = .52，NNT = 4.1，P = .03）。结论：预防性LMWH与创伤患者VTE的降低有关。

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