Venous thromboembolism prophylaxis effective in pediatric trauma patients: JAMA

The median (IQR) age of the 460 high-risk pediatric trauma patients was 14.5 years, of which, 313 patients (68%) were male and 147 patients (32%) were female. The number of high-risk variables were 3, and the median (IQR) Injury Severity Score (ISS) was 23 (16–30). 62(13.5%) of the 251 (54.5%) patients who had cVTE received it within 24 hours of their arrival. The patients with greater ISS and more high-risk characteristics were the individuals who underwent cVTE after a 24-hour period. The bleeding in the central nervous system was the most frequent cause of delayed cVTE.

Out of 25 patients, there were 28 VTE episodes (5.4%). Of 62 patients (1.6%) who received cVTE within 24 hours, 13 of 189 patients (6.9%) who had cVTE after 24 hours, and 11 of 209 (5.3%) who did not get cVTE, only one patient experienced VTE. A longer period of time between admission and the start of cVTE was substantially linked to VTE. While receiving cVTE, no bleeding problems were observed in the patients. Overall, the results suggests it is safe to use VTE prophylaxis in pediatric trauma patients at high risk and future research should concentrate on the best time to start prophylaxis and how to overcome obstacles to following recommendations.

Source:

Witte, A. B., Van Arendonk, K., Bergner, C., Bantchev, M., Falcone, R. A., Jr, Moody, S., Hartman, H. A., Evans, E., Thakkar, R., Patterson, K. N., Minneci, P. C., Mak, G. Z., Slidell, M. B., Johnson, M., Landman, M. P., Markel, T. A., Leys, C. M., Cherney Stafford, L., Draper, J., … Ehrlich, P. F. (2024). Venous Thromboembolism Prophylaxis in High-Risk Pediatric Trauma Patients. In JAMA Surgery. American Medical Association (AMA). https://doi.org/10.1001/jamasurg.2024.2487