Evidence map›Paper›PMID 39296601›Full record

ArticleTrauma surgery & acute care open2024

Venous thromboembolism prophylaxis prescribing patterns for patients with orthopedic trauma: a clinical vignette survey.

Nathan N O'Hara, Deborah M Stein, Elliott R Haut, Stephen Breazeale, Katherine P Frey, Gerard P Slobogean, Reza Firoozabadi, Renan Castillo, Robert V O'Toole

Abstract read
In one paragraph

Article in Trauma surgery & acute care open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Is aspirin enough for venous thromboembolism prophylaxis?Trauma surgery & acute care open · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Nathan N O'HaraUniversity of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0003-0537-3474
Deborah M SteinUniversity of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0003-3683-3963
Elliott R HautDepartment of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0001-7075-771X
Stephen BreazealeBaptist Health South Florida Inc, Coral Gables, Florida, USA.
Katherine P FreyJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Gerard P SlobogeanUniversity of Maryland School of Medicine, Baltimore, Maryland, USA.
Reza FiroozabadiOrthopaedic Surgery and Sports Medicine, University of Washington, Seattle, Washington, USA.
Renan CastilloJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Robert V O'TooleUniversity of Maryland School of Medicine, Baltimore, Maryland, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractBackground: A recent clinical trial suggested aspirin is a viable alternative to enoxaparin for venous thromboembolism (VTE) prophylaxis in patients after orthopedic trauma. The initial impact of these findings on VTE prophylaxis prescribing is unknown. The study aimed to evaluate stated VTE prophylaxis prescribing patterns among clinicians who treat patients after orthopedic trauma. Methods: For this clinical vignette survey, we recruited surgeons and advanced practice providers who prescribed VTE prophylaxis to patients with orthopedic trauma across 40 states. Clinicians were shown seven clinical vignettes describing hypothetical patients with orthopedic trauma based on their fracture type, treatment, VTE risk factors, additional injuries and health insurance status. We assessed the stated VTE prophylaxis medications prescribed in-hospital and at discharge, patient factors associated with changes in medication prescribing preferences and practice variation by specialty and provider training. Results: Among the 287 respondents, the median age was 43 years (IQR, 38-50), and 154 (weighted average, 63%) were men. For in-hospital VTE prophylaxis, enoxaparin was prescribed in 83% of the presented scenarios, and aspirin was prescribed in 13% (p<0.001). At discharge, aspirin was prescribed more frequently than enoxaparin (50% vs 41%, p<0.001). Healthcare providers with an aspirin discharge preference were 12% more likely to switch to enoxaparin if the patient had additional VTE risk factors, such as obesity (95% CI 4% to 19%, p=0.005). Conclusions: Despite new clinical evidence, in-hospital VTE prophylaxis prescribing practices for patients with orthopedic trauma remain consistent with those reported a decade ago. However, compared with historical data, clinicians have significantly increased their preference for aspirin for thromboprophylaxis at discharge-unless the patient has additional thromboembolic risk factors. Level of evidence: 5-expert opinion.

Indexed as

orthopaedicstreatment outcomeVenous thromboembolism

Identifiers

PMID39296601
PMCPMC11409350

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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.