{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:46:27Z","timestamp":1770745587685,"version":"3.49.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Severely injured patients are at particularly high risk for venous thromboembolism (VTE). Although thromboprophylaxis (PPX) is employed during the inpatient period, patients may continue to be at high risk after discharge. Comparative evidence from surgical subspecialities (eg oncology) reveals benefits of postdischarge (ie extended) PPX. We hypothesized that an extended, postinjury oral thromboprophylaxis regimen would be cost-effective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>STUDY DESIGN:<\/jats:title>\n            <jats:p>A cost-utility model compared no PPX with a 30-day course of apixaban, dabigatran, enoxaparin, fondaparinux, or rivaroxaban in trauma patients. Immediate events including deep venous thrombosis, pulmonary embolus, or bleeding within 30 days of injury were modeled in a decision tree with patients entering a Markov process to account for sequelae of VTE, including postthrombotic syndrome and chronic thromboembolic pulmonary hypertension. Effectiveness was measured in quality-adjusted life years. One-way and probabilistic sensitivity analyses were performed to identify conditions under which the preferred PPX strategy changed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Rivaroxaban was the dominant strategy (ie less costly and more effective) compared with no PPX or alternative regimens, delivering 30.21 quality-adjusted life years for $404,546.38. One-way sensitivity analyses demonstrated robust preference for rivaroxaban. When examining only patients with moderate-high or high VTE Risk Assessment Profile scores, rivaroxaban remained the preferred strategy. Probabilistic sensitivity analysis demonstrated a preference for rivaroxaban in 100% of cases at a standard willingness-to-pay threshold of $100,000\/quality-adjusted life year.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>A 30-day course of rivaroxaban is a cost-effective extended thromboprophylaxis strategy in trauma patients in this theoretical study. Prospective studies of postdischarge thromboprophylaxis to prevent postinjury VTE are warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/xcs.0000000000000033","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T01:10:46Z","timestamp":1649121046000},"page":"86-94","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Investigation into the Cost-Effectiveness of Extended Posttraumatic Thromboprophylaxis"],"prefix":"10.1097","volume":"234","author":[{"given":"Kristina J","family":"Nicholson","sequence":"first","affiliation":[{"name":"From the Department of Surgery (Nicholson, Rosengart, Neal, Myers), University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R","family":"Rosengart","sequence":"additional","affiliation":[{"name":"From the Department of Surgery (Nicholson, Rosengart, Neal, Myers), University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth J","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Smith), University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew D","family":"Neal","sequence":"additional","affiliation":[{"name":"From the Department of Surgery (Nicholson, Rosengart, Neal, Myers), University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara P","family":"Myers","sequence":"additional","affiliation":[{"name":"From the Department of Surgery (Nicholson, Rosengart, Neal, Myers), University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"R1-20250821","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1111\/j.1538-7836.2005.01415.x","article-title":"Venous thromboembolism: disease burden, outcomes and risk factors.","volume":"3","author":"Heit","year":"2005","journal-title":"J Thromb Haemost"},{"key":"R2-20250821","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1097\/TA.0000000000002039","article-title":"Hidden burden of venous thromboembolism after trauma: a national analysis.","volume":"85","author":"Rattan","year":"2018","journal-title":"J Trauma Acute Care Surg"},{"key":"R3-20250821","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1053\/j.tvir.2017.07.002","article-title":"Epidemiology, pathophysiology, stratification, and natural history of pulmonary embolism.","volume":"20","author":"Giordano","year":"2017","journal-title":"Tech Vasc Interv Radiol"},{"key":"R4-20250821","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00423-004-0472-0","article-title":"Surgical trauma: hyperinflammation versus immunosuppression?","volume":"389","author":"Menger","year":"2004","journal-title":"Langenbecks Arch Surg"},{"key":"R5-20250821","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/TA.0000000000001494","article-title":"Unfractionated heparin versus low-molecular-weight heparin for venous thromboembolism prophylaxis in trauma.","volume":"83","author":"Jacobs","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"R6-20250821","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1001\/archinte.1974.00320150040003","article-title":"Undiagnosed diseases in an aging population. 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