Optimal Timing for Initiation of Thromboprophylaxis After Hepatic Angioembolization
Authors' conclusion
For these patients, initiation of TPX at 48 to 72 hours achieves the safest balance in minimizing bleeding while reducing the risk of VTE.
Study context
- Population
- Trauma patients who underwent hepatic angioembolization within 24 h; <24-h LOS and other serious injuries excluded1,370 initial angioembolization
- Participants
- 1,550 patients
- Exposure
- Timing of thromboprophylaxis initiation after hepatic angioembolization
- Outcome
- Bleeding complications and VTE by TPX timing
Methodological detailsnational registry (ACS TQIP 2017–2019)
- National registry (ACS TQIP 2017–2019)
Main finding
As reported in the abstract
Bleeding complications, TPX within 24 h vs later (P <0.001)
20.0% vs 8.9%
Bleeding complications, TPX within 48 h vs later (P =0.013)
13.2% vs 8.4%
Venous thromboembolism (VTE), TPX after 48 h vs earlier (P =0.025)
6.3% vs 3.3%
Observational data: associations, not effects.
Further findings
Bleeding complications, hepatic surgery before angioembolization (subgroup, n = 180)
- TPX within 24 h vs later (P <0.001)
- 72% vs 20%
- TPX within 48 h vs later (P <0.001)
- 50% vs 17%
- TPX within 72 h vs later (P =0.001)
- 37% vs 14%
DVT, hepatic surgery before angioembolization (subgroup)
- TPX after 96 h vs earlier (P =0.023)
- 14.3% vs 3.1%
Original publication
Optimal Timing for Initiation of Thromboprophylaxis After Hepatic Angioembolization. Ann Surg. Published 11 June 2024. doi:10.
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