title: Efficacy of early anticoagulant therapy for venous thromboembolism in polytrauma patients in the acute phase.
abstract: OBJECTIVE
  To determine whether antithrombotic therapy with warfarin is effective and safe in patients who developed venous thromboembolism in the acute stage of polytrauma, which is associated with bleeding risk.
  
  
  METHODS
  A retrospective study of 11 patients (8 males, 3 females; mean age, 39.8 years; injury severity score, 30.1; no fatalities) with deep venous thromboembolism and/or pulmonary embolism who were medicated with heparin and warfarin during their iCU stay.
  
  
  RESULTS
  Thrombosis was diagnosed at an average of 11.8 days after admission. Thrombus formation was confirmed in pulmonary arteries in 5 cases and in deep veins in 9 cases. Diagnosis was based on Doppler ultrasound findings in 6 cases and on computed tomography findings in 5 cases. anticoagulant therapy was used in 10 cases, but not in 1 case with cerebral contusion. approximately 33 days after starting anticoagulant therapy, thrombi had disappeared or were reduced in size in 9 of 10 patients with no complications observed.
  
  
  CONCLUSIONS
  Heparin and warfarin therapy cleared deep vein and pulmonary artery thrombosis after polytrauma without any bleeding complications. Further studies are necessary to determine the safe anticoagulant dosage and duration for rapid thrombus removal.
authors.affiliation: Tokai University School of Medicine, Department of Emergency and Critical Care Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. yoshihide@is.icc.u-tokai.ac.jp
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Sadaki
authors.initials: S
authors.lastname: Inokuchi
authors.forename: Tomoatsu
authors.initials: T
authors.lastname: Tsuji
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamagiwa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Iizuka
authors.forename: Seiji
authors.initials: S
authors.lastname: Morita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ootsuka
authors.forename: Kazuki
authors.initials: K
authors.lastname: Akieda
mesh_terms: D000210:Acute-Phase Reaction; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications*; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin