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Published on: October 12, 2012

Increased use of enoxaparin in pediatric trauma patients

Johanna R Askegard-Giesmann1, Sarah H O'Brien, Wei Wang

  • 1Department of Pediatric Surgery, Nationwide Children's Hospital and The Ohio State University, Columbus, OH 43205, USA.

Journal of Pediatric Surgery
|May 19, 2012
PubMed

Insights

Enoxaparin use increased in pediatric trauma patients, despite stable venous thromboembolism (VTE) rates. This suggests growing use of pharmacologic thromboprophylaxis in pediatric trauma care.

Area of Science:

  • Pediatric Traumatology
  • Pharmacology
  • Vascular Medicine

Background:

  • Venous thromboembolism (VTE) occurs in 0.7-4.2 per 1000 pediatric trauma admissions.
  • Current guidelines for prophylactic anticoagulation in children are lacking.
  • Enoxaparin is a common anticoagulant used for VTE prevention.

Purpose of the Study:

  • To examine the utilization trends of enoxaparin in pediatric trauma patients.
  • To assess the association between enoxaparin use and VTE diagnosis in this population.
  • To identify factors influencing enoxaparin prescription in pediatric trauma.

Main Methods:

  • Utilized the Pediatric Health Information System database (2001-2008).
  • Identified pediatric trauma patients (0-18 years) using ICD-9 codes.
  • Analyzed enoxaparin prescriptions and VTE diagnoses via pharmacy and ICD-9 codes.
  • Employed logistic regression to determine patient and hospital characteristics associated with VTE and enoxaparin use.

Main Results:

  • Over 260,000 pediatric trauma patients were analyzed.
  • Enoxaparin was prescribed to 1.23% of patients; 1.12% received it without a VTE diagnosis.
  • VTE incidence remained stable (0.23%-0.28%), while enoxaparin use rose (0.75%-1.54%).
  • Enoxaparin use increased significantly in patients without VTE (0.65%-1.43%).
  • VTE was linked to pelvic fractures, ICU stay, and central venous catheters (P < .017).

Conclusions:

  • Enoxaparin use has significantly increased in pediatric trauma patients.
  • This trend suggests a rise in pharmacologic thromboprophylaxis in pediatric trauma centers.
  • Despite increased use, VTE incidence remained stable, warranting further investigation into appropriate prophylaxis strategies.
Abstract

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