A Retrospective Study of Preventive Anticoagulant Therapy Among Trauma Patients in Yichang Area Through Clinical Data Review and Clinician Survey

Background: Trauma-induced coagulopathy is one of the important causes for deaths after trauma. This study aimed to explore the current state of preventive anticoagulation therapy and the clinical factors affecting the application of anticoagulation guidelines. Methods: This study retrospectively involved 787 trauma patients treated at our hospital from January 2017 to November 2022 via review of medical records. A questionnaire survey was assigned to the clinicians to evaluate the current methods and opinions on preventive anticoagulation therapy. The time of the first anticoagulation therapy refers to the time from admission to the initiation of the first anticoagulation treatment. Results: A total of 787 trauma patients were included in this study, of whom 68.74% received anticoagulant therapy, mainly using low-molecular-weight heparin calcium. Thrombotic events happened in 14.61% of these patients. Binary logistic regression analysis showed that age, injury severity score, length of hospital stay, presence or absence of thrombotic events, and whether or not lower extremity vascular ultrasound and pulmonary CT re-examination were performed were significant factors affecting the use or non-use of anticoagulation therapy. A significant association was found between the daily dose of anticoagulant (P < 0.001) and the occurrence of thrombotic events, as well as between the time of the first anticoagulation therapy (P < 0.001) and the occurrence of thrombotic events. Logistic regression analysis showed that age, department of first visit, daily dose of anticoagulant drugs, time of first anticoagulation and the lower extremity vascular ultrasound and lung CT were reexamined were significant factors affecting the occurrence of thrombotic events (P< 0.05). The questionnaire showed that 97% of physicians consider prophylactic anticoagulant therapy for trauma patients but there were significant differences in the choice and practice of anticoagulant therapy among different departments. Conclusion: The current study showed that multiple factors may significantly associate with the use or non-use of anticoagulation therapy and the occurrence of thrombotic events. There were also significant differences in the method and opinions in treating trauma patients and using anticoagulation therapy among different clinicians from different departments. Keywords: trauma patients, anticoagulation therapy, prophylactic measures, clinical practice, individualized therapy