{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:03:15Z","timestamp":1780545795099,"version":"3.54.1"},"reference-count":19,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal surgery patients have a disproportionate risk of venous thromboembolism (VTE); thus, efforts to mitigate these events include both pre- and postoperative chemoprophylaxis. No studies have compared the efficacy and safety of low-molecular weight heparin (LMWH) and low-dose unfractionated heparin (UFH) as preoperative chemoprophylactic agents in colorectal surgery patients. We hypothesize that colorectal surgery patients who receive preoperative prophylactic doses of LMWH or UFH will have similar rates of VTE and bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Surgical Quality Improvement Program (NSQIP) database was queried for adult patients who had elective colorectal operations at a single institution from October 2018 to November 2022. Patients were separated based on preoperative chemoprophylaxis with LMWH (PRE LMWH), UFH (PRE UFH), or no preoperative chemoprophylaxis (NO PRE). All patients received enoxaparin for postoperative chemoprophylaxis. Primary outcomes were VTE rates and bleeding as defined by postoperative blood transfusion. Statistical analysis included Chi-squared test, Fishers exact test, univariate, and multivariate regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 596 patients were eligible. PRE LMWH n = 82, PRE UFH n = 178, and NO PRE n = 336. PRE LMWH had an increased risk of bleeding relative to PRE UFH (23% vs 6%,\n                      <jats:italic toggle=\"yes\">P &lt; 0.01<\/jats:italic>\n                      ). PRE LMWH was an independent predictor of postoperative blood transfusion (OR = 1.72, 95% CI [1.43, 2.03],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). There was no difference in VTE rates among all 3 groups (\n                      <jats:italic toggle=\"yes\">P = .20<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>For CRS patients, preoperative initiation of LMWH VTE prophylaxis increases the risk of bleeding and transfusion when compared to UFH and NO PRE without decreasing the rate of VTE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251397588","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T07:54:16Z","timestamp":1763452456000},"page":"1532-1538","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Administration of Low-Molecular Weight Heparin is Associated With Increased Transfusion Rate in Elective Colorectal Surgery Patients"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5007-1198","authenticated-orcid":false,"given":"Samantha L.","family":"Speroni","sequence":"first","affiliation":[{"name":"Virginia Tech Carilion School of Medicine, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl J.","family":"Buchholz","sequence":"additional","affiliation":[{"name":"Carilion Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S.","family":"Gates","sequence":"additional","affiliation":[{"name":"Carilion Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie L.","family":"Bower","sequence":"additional","affiliation":[{"name":"Virginia Tech Carilion School of Medicine, VA, USA"},{"name":"Carilion Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan R.","family":"Collier","sequence":"additional","affiliation":[{"name":"Virginia Tech Carilion School of Medicine, VA, USA"},{"name":"Carilion Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9124-1701","authenticated-orcid":false,"given":"Farrell C.","family":"Adkins","sequence":"additional","affiliation":[{"name":"Virginia Tech Carilion School of Medicine, VA, USA"},{"name":"Carilion Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Nussbaum","sequence":"additional","affiliation":[{"name":"Virginia Tech Carilion School of Medicine, VA, USA"},{"name":"Carilion Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2169-0082","authenticated-orcid":false,"given":"Jacob R.","family":"Gillen","sequence":"additional","affiliation":[{"name":"Virginia Tech Carilion School of Medicine, VA, USA"},{"name":"Carilion Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2018.12.013"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000982"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200103000-00020"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012385"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.02083.x"},{"key":"e_1_3_3_7_2","unstructured":"Pannucci CJ Fleming KI Bertolaccini CB Prazak AM Huang LC Pickron TB. Assessment of anti\u2013factor Xa levels of patients undergoing colorectal surgery given once-daily enoxaparin prophylaxis: a clinical study examining enoxaparin."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001856"},{"issue":"4","key":"e_1_3_3_9_2","first-page":"279","article-title":"Prophylaxis in elective colorectal surgery: the cost of ignoring the evidence","volume":"46","author":"Wasey N","year":"2003","unstructured":"Wasey N, Baughan J, de Gara CJ. Prophylaxis in elective colorectal surgery: the cost of ignoring the evidence. Can J Surg. 2003;46(4):279-284.","journal-title":"Can J Surg"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2021.07.687"},{"issue":"1","key":"e_1_3_3_11_2","first-page":"1","article-title":"The impact of blood transfusion on recurrence and mortality following colorectal cancer resection: a propensity score analysis of 4,030 patients","volume":"8","author":"Wu HL","year":"2018","unstructured":"Wu HL, Tai YH, Lin SP, Chan MY, Chen HH, Chang KY. The impact of blood transfusion on recurrence and mortality following colorectal cancer resection: a propensity score analysis of 4,030 patients. Sci Rep. 2018;8(1):1-8.","journal-title":"Sci Rep"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005258.pub3"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrad044"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005697"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-020-00872-w"},{"issue":"4","key":"e_1_3_3_16_2","first-page":"CD001217","article-title":"Heparins and mechanical methods for thromboprophylaxis in colorectal surgery","author":"Wille-J\u00f8rgensen P","year":"2003","unstructured":"Wille-J\u00f8rgensen P, Rasmussen MS, Andersen BR, Borly L. Heparins and mechanical methods for thromboprophylaxis in colorectal surgery. Cochrane Database Syst Rev. 2003;(4):CD001217.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000002975"},{"issue":"1","key":"e_1_3_3_18_2","first-page":"15","article-title":"Clinical practice guidelines for enhanced recovery after Colon and rectal surgery from the American society of Colon and rectal surgeons and the society of American gastrointestinal and endoscopic surgeons","volume":"66","author":"Irani JL","year":"2023","unstructured":"Irani JL, Hedrick TL, Miller TE, et al. Clinical practice guidelines for enhanced recovery after Colon and rectal surgery from the American society of Colon and rectal surgeons and the society of American gastrointestinal and endoscopic surgeons. Surg Endosc. 2023;66(1):15-40.","journal-title":"Surg Endosc"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003442"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800840817"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251397588","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251397588","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251397588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:17:42Z","timestamp":1780543062000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251397588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/00031348251397588"],"URL":"https:\/\/doi.org\/10.1177\/00031348251397588","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]}}}