Practice variation in venous thromboembolism prophylaxis in adolescent trauma patients: A comparative analysis of pediatric, adult, and mixed trauma centers - 21/11/24
, Amy H. Kaji b, George A. Singer a, Alexander C. Schwed a, Jessica A. Keeley aAbstract |
Introduction |
Adolescent trauma patients are at increased risk of venous thromboembolism (VTE). It is unclear whether VTE prophylaxis practice patterns differ across trauma center types.
Methods |
The ACS-TQP database was queried for patients aged 12-17 admitted to a pediatric, adult, or mixed level I/II trauma center. VTE prophylaxis was compared between center types. Preplanned subgroup analyses were performed to evaluate guideline adherence.
Results |
Of 101,010 patients included, 35 % were treated at a pediatric trauma center (PTC), 43 % at a mixed trauma center (MTC), and 22 % at an adult trauma center (ATC). VTE prophylaxis was more common at ATCs and MTCs compared to PTCs (51.0 % vs 24.9 % vs 5.0 %,p < 0.001). This trend persisted in subgroup analyses of patients aged 16–17 (63.8 % vs 40.5 % vs 6.4 %,p < 0.001) and with injury severity score greater than 25 (83.8 % vs 74.0 % vs 35.1 %,p < 0.001).
Conclusion |
VTE prophylaxis is administered more frequently to adolescent trauma patients treated at ATCs and MTCs compared to PTCs despite published guidelines. Prospective studies are needed to assess the clinical utility of VTE prophylaxis in the adolescent trauma population.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Adolescents managed at adult trauma centers are more likely to receive VTE prophylaxis. |
• | Pediatric centers have disproportionately low adherence to VTE prophylaxis guidelines. |
• | Overall VTE incidence is low and not clinically different between center types. |
Keywords : Venous thromboembolism, VTE prophylaxis, Pediatric trauma, VTE prophylaxis guidelines, Trauma centers
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Vol 238
Articolo 115994- dicembre 2024 Ritorno al numero
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