title: Increased use of enoxaparin in pediatric trauma patients.
abstract: OBJECTIVE
  Venous thromboembolism (VTE) in pediatric trauma patients has been reported from 0.7 to 4.2 patients per 1000 admissions. There are no clear guidelines for prophylactic anticoagulation in children. The purpose of this study was to examine the use of enoxaparin in pediatric trauma patients.
  
  
  METHODS
  The Pediatric Health Information System database was queried from 2001 to 2008 for patients 0 to 18 years with a primary diagnosis of trauma based on International Classification of Diseases, Ninth Revision, codes. Patients who received enoxaparin and/or diagnosed with VTE were identified using pharmacy and International Classification of Diseases, Ninth Revision, codes. Logistic regression was used to identify patient and hospital characteristics associated with VTE and enoxaparin use.
  
  
  RESULTS
  Among 260,078 pediatric trauma patients, 3195 were prescribed enoxaparin (1.23%), 2915 (1.12%) of whom were given enoxaparin without a diagnosis of VTE. The incidence of VTE remained stable (0.23%-0.28%), whereas the use of enoxaparin increased (0.75%-1.54%), especially in patients without VTE (0.65%-1.43%). Venous thromboembolism was significantly associated with pelvic fractures, intensive care unit stay, and central venous catheters (P = .017, P < .001, P < .001).
  
  
  CONCLUSIONS
  Despite a stable VTE incidence, the use of enoxaparin significantly increased in pediatric trauma patients, suggesting that use of pharmacologic thromboprophylaxis is increasing in pediatric trauma centers.
authors.affiliation: Department of Pediatric Surgery, Nationwide Children's Hospital and The Ohio State University, Columbus, OH 43205, USA.
authors.forename: Johanna R
authors.initials: JR
authors.lastname: Askegard-Giesmann
authors.forename: Sarah H
authors.initials: SH
authors.lastname: O'Brien
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Brian D
authors.initials: BD
authors.lastname: Kenney
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004363:Drug Utilization / Q000639:trends*; D017984:Enoxaparin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006776:Hospitals, Pediatric / Q000639:trends*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D014193:Trauma Centers / Q000639:trends*; D014481:United States; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents