Evidence map›Paper›PMID 28900890›Full record

ArticleAnnals of intensive care2017

High level of venous thromboembolism in critically ill trauma patients despite early and well-driven thromboprophylaxis protocol.

S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07506473 (Intermediate Versus Standard Dose Enoxaparin to Prevent Venous Thromboembolism in Severe Trauma Patients), which is not on this map. Cited by 32 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 2 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07506473 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Intermediate Versus Standard Dose Enoxaparin to Prevent Venous Thromboembolism in Severe Trauma Patients: a Multicenter Double Blind Randomised Controlled Trial

TypeinterventionalSponsorUniversity Hospital, GrenobleRan2026 to 2028Enrolled540ConditionsSevere Trauma Patient, Venous ThromboembolismArmsEnoxaparin standard dose, Enoxaparin intermediate dose
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.

  1. Pooled it
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  9. Intensivist performed compression ultrasound (IPCUS) for screening and early detection of deep venous thrombosis in trauma intensive care unit: a prospective study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
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  13. Review
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  17. Observational
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  19. Trauma-induced pulmonary thromboembolism: What's update?Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2022
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

S R HamadaDepartment of Anaesthesia and Critical Care, AP-HP, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, University Paris-Sud, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France. sophiehamada@hotmail.com.ORCID http://orcid.org/0000-0001-8405-5997
C EspinaDepartment of Anaesthesia and Critical Care, AP-HP, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, University Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
T GuedjDepartment of Radiology, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, University Paris-Sud, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
R BuaronDepartment of Radiology, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, University Paris-Sud, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
A HarroisDepartment of Anaesthesia and Critical Care, AP-HP, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, University Paris-Sud, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
S FigueiredoDepartment of Anaesthesia and Critical Care, AP-HP, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, University Paris-Sud, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
J DuranteauDepartment of Anaesthesia and Critical Care, AP-HP, Hôpital Bicêtre, Hôpitaux Universitaires Paris Sud, University Paris-Sud, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
Assistance Publique – Hôpitaux de Paris · FRBicêtre Hospital · FRUniversité Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVenous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol.

methodsThis was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre. We enrolled consecutive primary trauma patients expected to be in intensive care for ≥48 h. Thromboprophylaxis was protocol driven. DVT screening was performed by duplex ultrasound of upper and lower extremities within the first 48 h, between 5 and 7 days and then weekly until discharge. We recorded VTE risk factors at baseline and on each examination day. Independent risk factors were analysed using a multivariate logistic regression.

resultsIn 153 patients with a mean Injury Severity Score of 23 ± 12, the prevalence of VTE was 30.7%, 95 CI [23.7-38.8] (29.4% DVT and 4.6% PE). The incidence was 18%, 95 CI [14-24] patients-week. The median time of apparition of DVT was 6 days [1; 4]. The global protocol compliance was 77.8% with a median time of introduction of the pharmacological prophylaxis of 1 day [1; 2]. We identified four independent risk factors for VTE: central venous catheter (OR 4.39, 95 CI [1.1-29]), medullar injury (OR 5.59, 95 CI [1.7-12.9]), initial systolic arterial pressure <80 mmHg (OR 3.64, 95 CI [1.3-10.8]), and pelvic fracture (OR 3.04, 95 CI [1.2-7.9]).

conclusionDespite a rigorous, protocol-driven thromboprophylaxis, critically ill trauma patients showed a high incidence of VTE. Further research is needed to tailor pharmacological prophylaxis and balance the risks and benefits.

Indexed as

Duplex ultrasoundRisk factorsSevere traumaThromboprophylaxisVenous thromboembolism

Identifiers

PMID28900890
PMCPMC5595705
OpenAlexW2754510069

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.