Design and Retrospective Application of a Spine Trauma DVT Prophylaxis Protocol on Level 1 Trauma Center Patient Database

Global Spine Journal, 2022 · DOI: 10.1177/2192568220979139 · Published: July 1, 2022

Cardiovascular Science Healthcare Trauma

Simple Explanation

This study reviews existing literature to create a protocol for preventing blood clots (DVT) in spine trauma patients. The goal is to find a safe way to use blood thinners after spine surgery, as there's concern they might cause bleeding. The team developed a protocol based on a review of 13 articles and input from a trauma committee. They then looked back at patient records to see how the protocol might have affected outcomes. The study found that using the protocol could have led to earlier intervention for some patients who developed DVTs. The authors believe the protocol will help surgeons make better decisions to prevent blood clots in trauma patients.

Study Duration

Not specified

Participants

466 patients with vertebral column fractures and/or spinal cord injuries

Evidence Level

Systematic literature review and retrospective application

Key Findings

1
Early anticoagulation may reduce VTE and PE without increased bleeding complications.
2
Early initiation of an anticoagulation protocol can significantly decrease venous thromboembolic events, especially DVTs.
3
Prophylactic IVC filter placement may lead to a lower incidence of PE and fatal PE among hospitalized trauma patients.

Research Summary

This study aimed to develop and retrospectively apply a DVT prophylaxis protocol for spine trauma patients. A systematic literature review was conducted, and a multidisciplinary team created a protocol. The protocol development involved reviewing literature and multidisciplinary discussions, resulting in a protocol that stratifies patients based on spinal cord injuries and neurological deficits. Retrospective application of the protocol to patient cases suggested potential benefits in earlier intervention and prevention of DVTs, highlighting the importance of timely and consistent DVT prophylaxis.

Practical Implications

Standardized DVT Prophylaxis

Implementation of a standardized protocol can lead to more consistent and timely administration of DVT prophylaxis in spine trauma patients.

Early Intervention

The protocol emphasizes early intervention, such as IVC filter placement or VTE surveillance, which may decrease the risk of developing a fatal PE.

Informed Clinical Decision Making

The treatment algorithm can assist trauma surgeons in evidence-based clinical decision making to avoid DVTs.

Study Limitations

1
Limited quantity of relevant articles based on search terms
2
Inconsistent dosing and selection of chemical anticoagulation agent across the retrospective cases
3
The protocol cannot replace sound medical decision-making across all specialties

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