Post-discharge venous thromboembolism prophylaxis in hospitalized trauma patients: A retrospective comparison of patients receiving versus not receiving post-discharge prophylaxis

• DOI: 10.1016/j.amjsurg.2023.10.032
• Publication Date: 2023-10-14T23:24:54Z
• Authors: Rachel M. Belcher; Annika B. Kay; Gabriel V. Fontaine; Margaret Baldwin; Joseph R. Bledsoe; Dave S. Collingridge; Sarah Majercik
• Keywords: Guideline; Hospital discharge; Major trauma

Risk of venous thromboembolism (VTE) in many trauma patients extends beyond hospitalization, but there is a paucity of evidence to guide the use of post-discharge prophylaxis (PDP).A retrospective cohort study of trauma patients deemed moderate-to-high risk for VTE (risk assessment profile score [RAP] ≥5) who were prescribed PDP based on an internal clinical guideline assessing injury pattern and mobility status. PDP patients were compared with those that did not receive post-discharge prophylaxis (NPDP).1512 patients were included. PDP group had higher mean RAP score (7.3 vs. 6.4, p ​< ​0.001), more likely to have a complex orthopedic fracture and underwent a longer median hospital (4.7 vs. 2.9 days, p ​< ​0.001). No difference between groups in 90-day VTE (11 [1.5 ​%] (PDP) vs. 8 [1.0 ​%] (NPDP), p ​= ​0.50), clinically relevant bleeding (p ​= ​0.58), or readmission (p ​= ​0.46).VTE incidence, clinically relevant bleeding, and readmission 90-days after hospital discharge were low and similar between PDP and NPDP groups. PDP prescribed in a presumably higher VTE risk trauma population may mitigate the long-term risk of VTE.