{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:10:00Z","timestamp":1788901800575,"version":"build-2803163510"},"reference-count":20,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"CNPq","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. vasc. bras."],"abstract":"<jats:p>Abstract  Background Patients with pelvic trauma are at high risk for deep vein thrombosis (DVT), but early initiation of thromboprophylaxis may increase bleeding risk in hemodynamically unstable individuals. The optimal timing for initiation of anticoagulation remains controversial.  Objectives To evaluate whether delayed initiation of pharmacologic prophylaxis is associated with a higher incidence of DVT in patients with pelvic trauma, after adjustment for age and activation of the massive transfusion protocol.  Methods This retrospective observational cohort study was conducted at a Level I trauma center from January 2022 to December 2023. Adult patients with computed tomography\u2013confirmed pelvic trauma who underwent Doppler ultrasonography during hospitalization were included. The primary exposure was initiation of pharmacologic prophylaxis within 48 hours (early) vs. after 48 hours (delayed). The primary outcome was occurrence of DVT during hospitalization. Multivariable logistic regression was conducted, adjusting for age and activation of the massive transfusion protocol.  Results A total of 62 patients were analyzed, with a mean age of 47.71 \u00b1 19.91 years and predominance of male sex (66.1%). The overall incidence of DVT was 32.3% (n=20). In the bivariate analysis, DVT incidence was 35.3% in the delayed group and 28.6% in the early group (p = 0.598). In the multivariable analysis, early initiation was not independently associated with the occurrence of DVT (OR 0.65; 95% CI 0.21\u20132.00; p = 0.456).  Conclusions Delayed initiation of thromboprophylaxis was not independently associated with a higher incidence of DVT after adjustment for age and activation of the massive transfusion protocol.<\/jats:p>","DOI":"10.1590\/1677-5449.202600402","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:33:09Z","timestamp":1788899589000},"source":"Crossref","is-referenced-by-count":0,"title":["Association between delayed thromboprophylaxis and the incidence of deep vein thrombosis in patients with pelvic trauma: a retrospective cohort adjusted for severity at a level I trauma center"],"prefix":"10.1590","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5814-6673","authenticated-orcid":false,"given":"Jihad Manaf El","family":"Sayed","sequence":"first","affiliation":[{"name":"Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Marum","family":"Olmedo","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adilia Maria Pires","family":"Sciarra","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Castiglioni","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo C\u00e9sar","family":"Espada","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"8","key":"ref1","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1007\/s00264-022-05431-z","article-title":"Thromboembolic events in pelvic and acetabulum fractures: a systematic review of the current literature on incidence, screening, and thromboprophylaxis","volume":"46","author":"Mahmoud SS","year":"2022","journal-title":"Int Orthop"},{"issue":"10294","key":"ref2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(20)32658-1","article-title":"Venous thromboembolism","volume":"398","author":"Khan F","year":"2021","journal-title":"Lancet"},{"issue":"7","key":"ref3","doi-asserted-by":"crossref","first-page":"2400","DOI":"10.1016\/j.injury.2022.04.009","article-title":"Pathophysiology in patients with polytrauma","volume":"53","author":"Pape HC","year":"2022","journal-title":"Injury"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s13054-023-04327-7","article-title":"The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition","volume":"27","author":"Rossaint R","year":"2023","journal-title":"Crit Care"},{"issue":"4","key":"ref5","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1001\/archsurg.1967.01330160037005","article-title":"Posttraumatic venous thrombosis","volume":"95","author":"Freeark RJ","year":"1967","journal-title":"Arch Surg"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"681","DOI":"10.2147\/CIA.S161191","article-title":"Deep vein thrombosis in bilateral lower extremities after hip fracture: a retrospective study of 463 patients","volume":"13","author":"Zhang BF","year":"2018","journal-title":"Clin Interv Aging"},{"issue":"2","key":"ref7","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1302\/0301-620X.104B2.BJJ-2021-0764.R2","article-title":"Assessment of deep vein thrombosis using routine pre- and postoperative duplex Doppler ultrasound in patients with pelvic trauma: a prospective study","volume":"104-B","author":"Cerbasi S","year":"2022","journal-title":"Bone Joint J"},{"issue":"1","key":"ref8","doi-asserted-by":"crossref","first-page":"51","DOI":"10.5704\/MOJ.2203.008","article-title":"Study of deep vein thrombosis screening by using ultrasound Doppler in patients with pelvic and acetabulum fractures requiring operative intervention","volume":"16","author":"Hadizie D","year":"2022","journal-title":"Malays Orthop J"},{"issue":"1","key":"ref9","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13017-017-0117-6","article-title":"Pelvic trauma: WSES classification and guidelines","volume":"12","author":"Coccolini F","year":"2017","journal-title":"World J Emerg Surg"},{"issue":"2","key":"ref10","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.suc.2023.10.001","article-title":"Management of pelvic trauma","volume":"104","author":"Baker JE","year":"2024","journal-title":"Surg Clin North Am"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jss.2020.08.077","article-title":"When is it safe to start pharmacologic venous thromboembolism prophylaxis after pelvic fractures? A prospective study from a Level I trauma center","volume":"258","author":"Schellenberg M","year":"2021","journal-title":"J Surg Res"},{"issue":"2","key":"ref12","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.injury.2021.09.047","article-title":"Early versus delayed thromboprophylaxis with LMWH in pelvic-acetabular trauma: a prospective study","volume":"53","author":"Shetty A","year":"2022","journal-title":"Injury"},{"issue":"12","key":"ref13","doi-asserted-by":"crossref","first-page":"2661","DOI":"10.1016\/j.ajem.2020.07.041","article-title":"Massive transfusion protocol in adult trauma population","volume":"38","author":"Meneses E","year":"2020","journal-title":"Am J Emerg Med"},{"issue":"10","key":"ref14","doi-asserted-by":"crossref","first-page":"4089","DOI":"10.1177\/00031348231175503","article-title":"Predictors of mortality in trauma patients receiving massive transfusion protocol","volume":"89","author":"Jebbia M","year":"2023","journal-title":"Am Surg"},{"issue":"2","key":"ref15","article-title":"Damage control in orthopaedical and traumatology","volume":"52","author":"Rondanelli AM","year":"2021","journal-title":"Colomb Med"},{"key":"ref16","series-title":"Pelvic trauma","author":"Tullington JE","year":"2023"},{"issue":"1","key":"ref17","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s13613-017-0315-0","article-title":"High level of venous thromboembolism in critically ill trauma patients despite early and well-driven thromboprophylaxis protocol","volume":"7","author":"Hamada SR","year":"2017","journal-title":"Ann Intensive Care"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/SLA.0000000000005157","article-title":"Efficacy and safety of low molecular weight heparin versus unfractionated heparin for prevention of venous thromboembolism in trauma patients: a systematic review and meta-analysis","volume":"275","author":"Tran A","year":"2022","journal-title":"Ann Surg"},{"key":"ref19","doi-asserted-by":"crossref","DOI":"10.1590\/1677-5449.202301071","article-title":"Diretrizes sobre trombose venosa profunda da Sociedade Brasileira de Angiologia e Cirurgia Vascular","volume":"23","author":"Sobreira ML","year":"2024","journal-title":"J Vasc Bras"},{"issue":"1","key":"ref20","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13018-022-02972-2","article-title":"Incidence and risk factors of preoperative deep venous thrombosis following pelvic and acetabular fractures: a retrospective case-control study","volume":"17","author":"Zhao W","year":"2022","journal-title":"J Orthop Surg Res"}],"container-title":["Jornal Vascular Brasileiro"],"original-title":["Associa\u00e7\u00e3o entre a tromboprofilaxia tardia e a incid\u00eancia de trombose venosa profunda em pacientes com trauma p\u00e9lvico: coorte retrospectiva ajustada para gravidade em um centro de trauma de n\u00edvel I"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S1677-54492026000100610&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:33:14Z","timestamp":1788899594000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1677-54492026000100610&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":20,"alternative-id":["S1677-54492026000100610"],"URL":"https:\/\/doi.org\/10.1590\/1677-5449.202600402","relation":{"is-translation-of":[{"id-type":"doi","id":"10.1590\/1677-5449.202600401","asserted-by":"subject"}]},"ISSN":["1677-7301","1677-5449"],"issn-type":[{"value":"1677-7301","type":"electronic"},{"value":"1677-5449","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20260040"}}