This multicentre pilot trial will assess the feasibility of a full-scale, randomized trial to determine whether bloodwork guided dosing of blood thinners reduces the risk of clotting in high-risk trauma patients. Patients will receive either standard of care dosing or dosing with adjustments based on bloodwork to achieve a minimum therapeutic threshold.
Patients 18 years of age or older admitted to a hospital ward or intensive care unit following a traumatic injury involving two or more body systems (head, chest, abdomen, pelvis, extremity) and meeting at least one of the following high-risk criteria previously identified in a recent systematic review (1): age ≥ 65, body mass index ≥ 30 kg/m2, injury severity score ≥ 16, pelvic injury with activity restrictions, lower extremity injury with activity restrictions, or surgery during the index hospitalization.
Greater than 7 days since time of injury.
Requirement for therapeutic anticoagulation or dual-antiplatelet therapy
Unable or unwilling to receive pharmacologic prophylaxis within 48 hours of admission.
History of allergic reaction or sensitivity to LMWH.
Alexandre Tran
Lead sponsor
Ottawa Hospital Research Institute
Sponsor institution