B. Faraon2, A. Alarhayem4, B. Pollock3, T. Perdomo1, P. Rhee1, S. Cohn1 1Saint Barnabas Hospital, Bronx, NY, USA 2CUNY School of Medicine, New York, NY, USA 3University Of California – Davis, Department Of Public Health Sciences, Sacramento, CA, USA 4Banner Health, Phoenix, AZ, USA
Introduction: Venous thromboembolic disease (VTE), encompassing pulmonary embolism (PE) and deep vein thrombosis (DVT), presents a significant concern in trauma patients undergoing lower limb amputations. This study identifies determinants for VTE among such patients using the National Trauma Databank (NTDB) dataset.
Methods: A historical cohort analysis was conducted using data from the NTDB from 2016 to 2023. Patients who underwent lower limb amputations were identified, and their VTE risk categorized by amputation level and anticoagulant regimen (low molecular weight heparin [LMWH] vs. unfractionated heparin (UH) was assessed.
Results: Among 11,911 lower limb amputations included in the analysis, the overall cumulative incidence of VTE was 6.9%. Notably, VTE incidence varied by amputation level, with above-knee amputations associated with a higher incidence (8.8%) compared to below-knee amputations (4.8%), p<0.01. Regarding the anticoagulant regimen, patients administered UH exhibited a
higher VTE incidence (7.5%) compared to those receiving LMWH (3.6%). Among patients with traumatic amputations with severe TBI (initial GCS<9), the incidence of VTE was 4 -fold higher (20.4% vs. 6.9%, p<0.001).
Conclusions: This study highlights the substantial burden of venous thromboembolic events in trauma patients undergoing lower limb amputations, with above-knee amputations, severe TBI, and unfractionated heparin use associated with an elevated incidence of venous thrombosis.