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pISSN 1225-1682
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    J Korean Fract Soc. 2015 Jan;28(1):82-92. Korean.
    Published online Jan 20, 2015.
    https://doi.org/10.12671/jkfs.2015.28.1.82
    Copyright © 2015 The Korean Fracture Society. All rights reserved.
    Review

    Prophylaxis and Management of Deep Vein Thrombosis in Trauma Patients

    Yong-Cheol Yoon, M.D. and Jae-Ang Sim, M.D., Ph.D.*
      • Regional Trauma Center, Gachon University Gil Hospital, Incheon, Korea.
      • *Department of Orthopaedic Surgery, Gachon University Gil Hospital, Incheon, Korea.
    • Address reprint requests to: Jae-Ang Sim, M.D., Ph.D. Department of Orthopaedic Surgery, Gachon University Gil Hospital, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-2645, Fax: 82-32-423-3384, Email: sim_ja@hanmail.net

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Tables

    Table 1
    Individual Risk Factors and the Risk Assessment Profile Score

    Table 2
    Ninth American College of Chest Physicians Guidelines for VTE Prevention (2012)

    Table 3
    Recommendations of the EAST Group for the Venous Thromboembolism Prophylaxis in Trauma Patients (2002)

    Notes

    Financial support: None.

    Conflict of interest: None.

    References

      1. Raskob GE, Silverstein R, Bratzler DW, Heit JA, White RH. Surveillance for deep vein thrombosis and pulmonary embolism: recommendations from a national workshop. Am J Prev Med 2010;38:S502–S509.
      1. Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol 2007;44:62–69.
      1. Knudson MM, Ikossi DG, Khaw L, Morabito D, Speetzen LS. Thromboembolism after trauma: an analysis of 1602 episodes from the American College of Surgeons National Trauma Data Bank. Ann Surg 2004;240:490–496.
        discussion 496-498.
      1. Paffrath T, Wafaisade A, Lefering R, et al. Trauma Registry of DGU: Venous thromboembolism after severe trauma: incidence, risk factors and outcome. Injury 2010;41:97–101.
      1. Chiasson TC, Manns BJ, Stelfox HT. An economic evaluation of venous thromboembolism prophylaxis strategies in critically ill trauma patients at risk of bleeding. PLoS Med 2009;6:e1000098.
      1. Reiff DA, Haricharan RN, Bullington NM, Griffin RL, McGwin G Jr, Rue LW 3rd. Traumatic brain injury is associated with the development of deep vein thrombosis independent of pharmacological prophylaxis. J Trauma 2009;66:1436–1440.
      1. Feliciano DV, Mattox KL, Moore EE. In: Trauma. 6th ed. New York: McGraw-Hill Medical; 2008. pp. 1251-1270.
      1. Geerts WH, Code KI, Jay RM, Chen E, Szalai JP. A prospective study of venous thromboembolism after major trauma. N Engl J Med 1994;331:1601–1606.
      1. Selby R, Geerts W, Ofosu FA, et al. Hypercoagulability after trauma: hemostatic changes and relationship to venous thromboembolism. Thromb Res 2009;124:281–287.
      1. Eppsteiner RW, Shin JJ, Johnson J, van Dam RM. Mechanical compression versus subcutaneous heparin therapy in postoperative and posttrauma patients: a systematic review and meta-analysis. World J Surg 2010;34:10–19.
      1. White RH. The epidemiology of venous thromboembolism. Circulation 2003;107 23 Suppl 1:I4–I8.
      1. Bendinelli C, Balogh Z. Postinjury thromboprophylaxis. Curr Opin Crit Care 2008;14:673–678.
      1. Dunbar NM, Chandler WL. Thrombin generation in trauma patients. Transfusion 2009;49:2652–2660.
      1. Brohi K, Cohen MJ, Ganter MT, et al. Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma 2008;64:1211–1217.
        discussion 1217.
      1. Sevitt S, Gallagher N. Venous thrombosis and pulmonary embolism. A clinico-pathological study in injured and burned patients. Br J Surg 1961;48:475–489.
      1. Datta I, Ball CG, Rudmik L, Hameed SM, Kortbeek JB. Complications related to deep venous thrombosis prophylaxis in trauma: a systematic review of the literature. J Trauma Manag Outcomes 2010;4:1.
      1. Sase T, Wada H, Kamikura Y, et al. Tissue factor messenger RNA levels in leukocytes compared with tissue factor antigens in plasma from patients in hypercoagulable state caused by various diseases. Thromb Haemost 2004;92:132–139.
      1. Kudsk KA, Fabian TC, Baum S, Gold RE, Mangiante E, Voeller G. Silent deep vein thrombosis in immobilized multiple trauma patients. Am J Surg 1989;158:515–519.
      1. Spinella PC, Carroll CL, Staff I, et al. Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries. Crit Care 2009;13:R151.
      1. Agarwal NK, Mathur N. Deep vein thrombosis in acute spinal cord injury. Spinal Cord 2009;47:769–772.
      1. Fujii Y, Mammen EF, Farag A, Muz J, Salciccioli GG, Weingarden ST. Thrombosis in spinal cord injury. Thromb Res 1992;68:357–368.
      1. Do JG, Kim DH, Sung DH. Incidence of deep vein thrombosis after spinal cord injury in Korean patients at acute rehabilitation unit. J Korean Med Sci 2013;28:1382–1387.
      1. Miranda AR, Hassouna HI. Mechanisms of thrombosis in spinal cord injury. Hematol Oncol Clin North Am 2000;14:401–416.
      1. Greenfield LJ, Proctor MC, Rodriguez JL, Luchette FA, Cipolle MD, Cho J. Posttrauma thromboembolism prophylaxis. J Trauma 1997;42:100–103.
      1. Gearhart MM, Luchette FA, Proctor MC, et al. The risk assessment profile score identifies trauma patients at risk for deep vein thrombosis. Surgery 2000;128:631–640.
      1. Kitagawa K, Sakoda S. Mechanism underlying thrombus formation in cerebral infarction. Rinsho Shinkeigaku 2009;49:798–800.
      1. Ruiz AJ, Hill SL, Berry RE. Heparin, deep venous thrombosis, and trauma patients. Am J Surg 1991;162:159–162.
      1. Seyfer AE, Seaber AV, Dombrose FA, Urbaniak JR. Coagulation changes in elective surgery and trauma. Ann Surg 1981;193:210–213.
      1. Owings JT, Bagley M, Gosselin R, Romac D, Disbrow E. Effect of critical injury on plasma antithrombin activity: low antithrombin levels are associated with thromboembolic complications. J Trauma 1996;41:396–405.
        discussion 405-406.
      1. Attar S, Boyd D, Layne E, McLaughlin J, Mansberger AR, Cowley RA. Alterations in coagulation and fibrinolytic mechanisms in acute trauma. J Trauma 1969;9:939–965.
      1. Enderson BL, Chen JP, Robinson R, Maull KI. Fibrinolysis in multisystem trauma patients. J Trauma 1991;31:1240–1246.
      1. Okamura K, Nakagawa I, Hidaka S, Okada Y, Kubo T, Kato T. Preoperative hypercoagulopathy in patients undergoing orthopedic lower extremity surgery. Masui 2008;57:1207–1212.
      1. Peetz D, Hafner G, Hansen M, et al. Dose-adjusted thrombosis prophylaxis in trauma surgery according to levels of D-Dimer. Thromb Res 2000;98:473–483.
      1. Meissner MH, Chandler WL, Elliott JS. Venous thromboembolism in trauma: a local manifestation of systemic hypercoagulability? J Trauma 2003;54:224–231.
      1. Engelman DT, Gabram SG, Allen L, Ens GE, Jacobs LM. Hypercoagulability following multiple trauma. World J Surg 1996;20:5–10.
      1. Dries DJ. Activation of the clotting system and complement after trauma. New Horiz 1996;4:276–288.
      1. Toro JB, Gardner MJ, Hierholzer C, et al. Long-term consequences of pelvic trauma patients with thromboembolic disease treated with inferior vena caval filters. J Trauma 2008;65:25–29.
      1. Nicolaides AN, Kakkar VV, Field ES, Fish P. Venous stasis and deep-vein thrombosis. Br J Surg 1972;59:713–717.
      1. Rossi EC, Green D, Rosen JS, Spies SM, Jao JS. Sequential changes in factor VIII and platelets preceding deep vein thrombosis in patients with spinal cord injury. Br J Haematol 1980;45:143–151.
      1. Myllynen P, Kammonen M, Rokkanen P, et al. The blood F VIII:Ag/F VIII:C ratio as an early indicator of deep venous thrombosis during post-traumatic immobilization. J Trauma 1987;27:287–290.
      1. Hak DJ. Prevention of venous thromboembolism in trauma and long bone fractures. Curr Opin Pulm Med 2001;7:338–343.
      1. Cothren CC, Smith WR, Moore EE, Morgan SJ. Utility of once-daily dose of low-molecular-weight heparin to prevent venous thromboembolism in multisystem trauma patients. World J Surg 2007;31:98–104.
      1. Matthiasson SE, Lindblad B, Bergqvist D. Prevention of experimental venous thrombosis in rabbits with low molecular weight heparin, dextran and their combinations, administered before or during induction of venous endothelial trauma. Thromb Res 1994;74:655–663.
      1. Becker DM. Venous thromboembolism: epidemiology, diagnosis, prevention. J Gen Intern Med 1986;1:402–411.
      1. Rogers FB, Cipolle MD, Velmahos G, Rozycki G, Luchette FA. Practice management guidelines for the prevention of venous thromboembolism in trauma patients: the EAST practice management guidelines work group. J Trauma 2002;53:142–164.
      1. Ganzer D, Gutezeit A, Mayer G. Potentials risks in drug prevention of thrombosis--low-molecular-weight heparin versus standard heparin. Z Orthop Ihre Grenzgeb 1999;137:457–461.
      1. Geerts WH, Jay RM, Code KI, et al. A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma. N Engl J Med 1996;335:701–707.
      1. Shackford SR, Davis JW, Hollingsworth-Fridlund P, Brewer NS, Hoyt DB, Mackersie RC. Venous thromboembolism in patients with major trauma. Am J Surg 1990;159:365–369.
      1. Dennis JW, Menawat S, Von Thron J, et al. Efficacy of deep venous thrombosis prophylaxis in trauma patients and identification of high-risk groups. J Trauma 1993;35:132–138.
        discussion 138-139.
      1. Upchurch GR Jr, Demling RH, Davies J, Gates JD, Knox JB. Efficacy of subcutaneous heparin in prevention of venous thromboembolic events in trauma patients. Am Surg 1995;61:749–755.
      1. Napolitano LM, Garlapati VS, Heard SO, et al. Asymptomatic deep venous thrombosis in the trauma patient: is an aggressive screening protocol justified? J Trauma 1995;39:651–657.
        discussion 657-659.
      1. Arnold JD, Dart BW, Barker DE, et al. Gold Medal Forum Winner. Unfractionated heparin three times a day versus enoxaparin in the prevention of deep vein thrombosis in trauma patients. Am Surg 2010;76:563–570.
      1. Weitz JI. Low-molecular-weight heparins. N Engl J Med 1997;337:688–698.
      1. Knudson MM, Lewis FR, Clinton A, Atkinson K, Megerman J. Prevention of venous thromboembolism in trauma patients. J Trauma 1994;37:480–487.
      1. Schwarcz TH, Quick RC, Minion DJ, Kearney PA, Kwolek CJ, Endean ED. Enoxaparin treatment in high-risk trauma patients limits the utility of surveillance venous duplex scanning. J Vasc Surg 2001;34:447–452.
      1. Green D, Lee MY, Lim AC, et al. Prevention of thromboembolism after spinal cord injury using low-molecular-weight heparin. Ann Intern Med 1990;113:571–574.
      1. Sems SA, Levy BA, Dajani K, Herrera DA, Templeman DC. Incidence of deep venous thrombosis after temporary joint spanning external fixation for complex lower extremity injuries. J Trauma 2009;66:1164–1166.
      1. Warwick D. Thromboembolic prophylaxis in orthopaedic trauma patients: a comparison between fixed dose and an individually adjusted dose of a low molecular weight heparin. Injury 1997;28:233–234.
      1. Malinoski D, Jafari F, Ewing T, et al. Standard prophylactic enoxaparin dosing leads to inadequate anti-Xa levels and increased deep venous thrombosis rates in critically ill trauma and surgical patients. J Trauma 2010;68:874–880.
      1. Lu JP, Knudson MM, Bir N, Kallet R, Atkinson K. Fondaparinux for prevention of venous thromboembolism in high-risk trauma patients: a pilot study. J Am Coll Surg 2009;209:589–594.
      1. Turpie AG. The safety of fondaparinux for the prevention and treatment of venous thromboembolism. Expert Opin Drug Saf 2005;4:707–721.
      1. Eriksson BI, Bauer KA, Lassen MR, Turpie AG. Steering Committee of the Pentasaccharide in Hip-Fracture Surgery Study. Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery. N Engl J Med 2001;345:1298–1304.
      1. Eriksson BI, Lassen MR, Colwell CW Jr. Efficacy of fondaparinux for thromboprophylaxis in hip fracture patients. J Arthroplasty 2004;19 7 Suppl 2:78–81.
      1. Rahman A, Colak MC, Ustünel L, Koc M, Kocakoc E, Colak C. A comparison of different treatment managements in patients with acute deep vein thrombosis by the effects on enhancing venous outflow in the lower limb. Med Sci Monit 2009;15:CR588–CR593.
      1. Xu B. DVT in acute stroke: the use of graduated compression stockings. Aust Fam Physician 2010;39:485–487.
      1. Arpaia G, Carpenedo M, Pistelli R, Mastrogiacomo O, Cimminiello C, Agnelli G. Attitudes to prescribing compression stockings for patients with acute DVT: the MASTER registry. J Thromb Thrombolysis 2009;28:389–393.
      1. Sachdeva A, Dalton M, Amaragiri SV, Lees T. Elastic compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev 2010;(7):CD001484.
      1. Velmahos GC, Nigro J, Tatevossian R, et al. Inability of an aggressive policy of thromboprophylaxis to prevent deep venous thrombosis (DVT) in critically injured patients: are current methods of DVT prophylaxis insufficient? J Am Coll Surg 1998;187:529–533.
      1. Gersin K, Grindlinger GA, Lee V, Dennis RC, Wedel SK, Cachecho R. The efficacy of sequential compression devices in multiple trauma patients with severe head injury. J Trauma 1994;37:205–208.
      1. Fisher CG, Blachut PA, Salvian AJ, Meek RN, O'Brien PJ. Effectiveness of pneumatic leg compression devices for the prevention of thromboembolic disease in orthopaedic trauma patients: a prospective, randomized study of compression alone versus no prophylaxis. J Orthop Trauma 1995;9:1–7.
      1. Kurtoglu M, Yanar H, Bilsel Y, et al. Venous thromboembolism prophylaxis after head and spinal trauma: intermittent pneumatic compression devices versus low molecular weight heparin. World J Surg 2004;28:807–811.
      1. Anglen JO, Bagby C, George R. A randomized comparison of sequential-gradient calf compression with intermittent plantar compression for prevention of venous thrombosis in orthopedic trauma patients: preliminary results. Am J Orthop (Belle Mead NJ) 1998;27:53–58.
      1. Spain DA, Bergamini TM, Hoffmann JF, Carrillo EH, Richardson JD. Comparison of sequential compression devices and foot pumps for prophylaxis of deep venous thrombosis in high-risk trauma patients. Am Surg 1998;64:522–525.
        discussion 525-526.
      1. Stannard JP, Lopez-Ben RR, Volgas DA, et al. Prophylaxis against deep-vein thrombosis following trauma: a prospective, randomized comparison of mechanical and pharmacologic prophylaxis. J Bone Joint Surg Am 2006;88:261–266.
      1. Winchell RJ, Hoyt DB, Walsh JC, Simons RK, Eastman AB. Risk factors associated with pulmonary embolism despite routine prophylaxis: implications for improved protection. J Trauma 1994;37:600–606.
      1. Greenfield LJ, Michna BA. Twelve-year clinical experience with the Greenfield vena caval filter. Surgery 1988;104:706–712.
      1. Rogers FB, Shackford SR, Ricci MA, Wilson JT, Parsons S. Routine prophylactic vena cava filter insertion in severely injured trauma patients decreases the incidence of pulmonary embolism. J Am Coll Surg 1995;180:641–647.
      1. Rodriguez JL, Lopez JM, Proctor MC, et al. Early placement of prophylactic vena caval filters in injured patients at high risk for pulmonary embolism. J Trauma 1996;40:797–802.
      1. Shackford SR, Cook A, Rogers FB, Littenberg B, Osler T. The increasing use of vena cava filters in adult trauma victims: data from the American College of Surgeons National Trauma Data Bank. J Trauma 2007;63:764–769.
      1. Khansarinia S, Dennis JW, Veldenz HC, Butcher JL, Hartland L. Prophylactic Greenfield filter placement in selected high-risk trauma patients. J Vasc Surg 1995;22:231–235.
      1. Velmahos GC, Kern J, Chan LS, Oder D, Murray JA, Shekelle P. Prevention of venous thromboembolism after injury: an evidence-based report: part II: analysis of risk factors and evaluation of the role of vena caval filters. J Trauma 2000;49:140–144.
      1. Helling TS, Kaswan S, Miller SL, Tretter JF. Practice patterns in the use of retrievable inferior vena cava filters in a trauma population: a single-center experience. J Trauma 2009;67:1293–1296.
      1. McKenzie S, Gibbs H, Leggett D, et al. An Australian experience of retrievable inferior vena cava filters in patients with increased risk of thromboembolic disease. Int Angiol 2010;29:53–57.
      1. Gorman PH, Qadri SF, Rao-Patel A. Prophylactic inferior vena cava (IVC) filter placement may increase the relative risk of deep venous thrombosis after acute spinal cord injury. J Trauma 2009;66:707–712.
      1. Phelan HA, Gonzalez RP, Scott WC, White CQ, McClure M, Minei JP. Long-term follow-up of trauma patients with permanent prophylactic vena cava filters. J Trauma 2009;67:485–489.
      1. Rosenthal D, Kochupura PV, Wellons ED, Burkett AB, Methodius-Rayford WC. Günther Tulip and Celect IVC filters in multiple-trauma patients. J Endovasc Ther 2009;16:494–499.
      1. Cherry RA, Nichols PA, Snavely TM, David MT, Lynch FC. Prophylactic inferior vena cava filters: do they make a difference in trauma patients? J Trauma 2008;65:544–548.
      1. Kearon C, Akl EA, Comerota AJ, et al. American College of Chest Physicians. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141:e419S–e494S.
      1. Cushman JG, Agarwal N, Fabian TC, et al. EAST Practice Management Guidelines Work Group. Practice management guidelines for the management of mild traumatic brain injury: the EAST practice management guidelines work group. J Trauma 2001;51:1016–1026.
      1. Treasure T, Hill J. NICE guidance on reducing the risk of venous thromboembolism in patients admitted to hospital. J R Soc Med 2010;103:210–212.
      1. Howard LS, Hughes RJ. NICE guideline: management of venous thromboembolic diseases and role of thrombophilia testing. Thorax 2013;68:391–393.
      1. Nj Langford;G. Stansby,L Avital.The management of venous thromboembolic diseases and the role of thrombophilia testing: summary of NICE Guideline CG144. Acute Med 2012;11:138–142.
    MeSH Terms
    Humans
    Venous Thrombosis*
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