Time is now: venous thromboembolism prophylaxis in blunt splenic injury

Am J Surg. 2016 Dec;212(6):1231-1236. doi: 10.1016/j.amjsurg.2016.09.026. Epub 2016 Sep 30.


Background: The safety and timing of venous thromboembolism (VTE) prophylaxis in patients with blunt splenic injuries is not well known. We hypothesized that early initiation of VTE prophylaxis does not increase failure of nonoperative management or transfusion requirements in these patients.

Methods: A retrospective review of trauma patients with blunt splenic injury was performed. Patients were compared based on initiation and timing of VTE prophylaxis (<24 hours, 24 to 48 hours, 48 to 72 hours, and >72 hours). Patients who received VTE prophylaxis were matched with those who did not. Primary outcomes included were operation or angioembolization.

Results: A total of 497 patients (256 received VTE prophylaxis and 241 did not) were included. There was no difference in the number of interventions based on presence of or time to VTE prophylaxis initiation.

Conclusions: Early initiation (<48 hours) of VTE prophylaxis is safe in patients with blunt splenic injuries treated nonoperatively, and may be safe as early as 24 hours.

Keywords: Blunt solid organ injury; Blunt splenic injury; Nonoperative management; VTE prophylaxis.

MeSH terms

  • Adult
  • Drug Administration Schedule
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spleen / injuries*
  • Treatment Outcome
  • Venous Thromboembolism / prevention & control*
  • Wounds, Nonpenetrating / complications*
  • Wounds, Nonpenetrating / therapy*
  • Young Adult


  • Fibrinolytic Agents