Administration of Venous Thromboembolism Chemoprophylaxis Within 12 Hours of Pelvic and Acetabular Surgery Has No Effect on Estimated Blood Loss, Perioperative Change in Hemoglobin, or Need for Transfusion.

OBJECTIVE To determine if preoperative administration of venous thromboembolism (VTE) chemoprophylaxis (PPx) prior to pelvic and acetabular fracture surgery affects estimated blood loss (EBL), perioperative change in hemoglobin (ΔHgb), or transfusion rates. DESIGN Retrospective cohort study. SETTING Level 1 trauma center, southeastern United States.Patients/Participants": All pelvic and acetabular surgeries performed between 4/2014 and 2/2020. MAIN OUTCOME MEASUREMENTS EBL, immediate and 24h post-op ΔHgb, and intra-/post-op transfusion. RESULTS In all 267 surgeries were included; 97 pre- and 170 post-change. Median ISS was 17 before vs 14 after the change. One surgeon retired and two started during the study, producing differences in acetabular approaches. Median surgical duration was longer post-change. Cohorts were otherwise similar. No differences were observed in EBL, ΔHgb, or transfusion rates. Rates of VTE and surgical site complications were unchanged. No VTE-related deaths occurred. In the as-treated analysis (63 patients given LMWH <12h pre-op vs 190 patients not given PPx), no differences were observed. CONCLUSIONS Administration of VTE PPx within 12h of pelvic and acetabular surgery had no effect on perioperative blood loss. This study is limited by changes in faculty, but it suggests that traumatologists need not advocate for holding VTE PPx before pelvic and acetabular trauma surgery. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.