Venous Thromboembolism Prophylaxis in High-Risk Pediatric Trauma Patients

Topic overview

Amanda B. Witte; Kyle Van Arendonk; Carisa Bergner; Martin Bantchev; Richard A. Falcone Jr; Suzanne Moody; Heather A. Hartman; Emily Evans; Rajan Thakkar; Kelli N. Patterson; Peter C. Minneci; Grace Z. Mak; Mark B. Slidell; MacKenton Johnson; Matthew P. Landman; Troy A. Markel; Charles M. Leys; Linda Cherney Stafford; Jessica Draper; David S. Foley; Cynthia Downard; Tracy M. Skaggs; Dave R. Lal; David Gourlay; Peter F. Ehrlich.

Question:  Does the application of high-risk guidelines allow for safe and appropriate administration of venous thromboembolism (VTE) prophylaxis following pediatric trauma?

Design, Setting, and Participants:  This cohort study was completed between October 2019 and October 2022 in 8 free-standing pediatric hospitals designated as American College of Surgeons level I pediatric trauma centers. Participants were pediatric trauma patients younger than 18 years who met defined high-risk criteria on admission. It was hypothesized that cVTE would be safe and reduce the incidence of VTE.

Findings:  In this cohort study applying high-risk criteria to guide VTE prophylaxis, more than half of patients received prophylaxis without any documented bleeding complications. Increased time to prophylaxis initiation was significantly associated with increased likelihood of developing VTE.

Intended audience: Healthcare professionals and clinicians.