Thromboembolic Events among Multiple Trauma Victims with Pelvic Fractures with Injury Severity Score Greater Than 16 with and without Deep Vein Thrombosis Prophylactic Doses of Enoxaparin


Multiple Trauma
Venous Thrombosis

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Ostovari A, Shahabinezhad A, Sarejloo S, Mesbahi SA, Saem J, Hamidianshirazi Y, Bananzadeh A, Paydar S, Salimi M. Thromboembolic Events among Multiple Trauma Victims with Pelvic Fractures with Injury Severity Score Greater Than 16 with and without Deep Vein Thrombosis Prophylactic Doses of Enoxaparin. Surg Insights [Internet]. 2022 Sep. 8 [cited 2022 Sep. 29];. Available from:


Introduction: Venous thromboembolism (VTE) is a common life-threatening complication in patients affected by severe trauma. The clinical manifestations of VTE are deep venous thrombosis (DVT) and pulmonary embolism (PE). Various prophylactic pharmacological strategies are used. We studied the efficacy of enoxaparin in preventing VTE in our level 1 trauma center. Materials and Methods: This cross-sectional study included patients with polytrauma with an Injury Severity Score (ISS) of greater than 16 units and a pelvis fracture diagnosis. Clinical features, laboratory data, and images were reviewed from medical documents. Moreover, the prophylactic medication regimens were recorded. Development of VTE was identified in patients, and a p-value <0.05 was considered statistically significant.  Results: A total of 327 patients were examined, of which 18 had developed VTE (5.5%). The frequency was relatively higher in males, cases with fractures, and cases with a history of VTE. Patients with two or more pelvic fracture sites and those with a history of VTE manifested  are statistically more likely to develop VTE than those with fewer than two pelvic fracture sites and no history of VTE (p-value = 0.02 and 0.006, respectively). Moreover, the administration of prophylactic doses of enoxaparin n had no statistically significant effect on VTE prevention (p-value = 0.08). Conclusion: In conclusion, we found no significant correlation between the prophylactic doses of enoxaparin and VTE probability. Furthermore, a history of VTE and more fracture sites would increase the probability of VTE.


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