• Shujhat Khan, Hussein Elghazaly, Areeb Mian, and Mansoor Khan.
• Department of Surgery, Imperial College London, London, UK. sk7015@ic.ac.uk.
• Eur J Trauma Emerg Surg. 2020 Dec 1; 46 (6): 1291-1299.

PurposeThere is much debate regarding the use of anticoagulation following vascular trauma. The aim of this meta-analysis was to compare the outcome of trauma following administration of anticoagulation medication.MethodsThe literature search was carried out using Ovid MEDLINE and PubMed databases to search for keywords and MeSH terms including "Anticoagulation", "Vascular Surgery", "Vascular Trauma", "Vascular Repair", "Repair" and "Wounds and Injuries".ResultsUse of anticoagulation was associated with a better prognosis for overall vascular trauma outcomes (weighted OR 0.46; 95% CI 0.34-0.64; P < 0.00001), as well as reduced risk of amputation for both lower and upper limb vascular trauma (weighted OR 0.42; 95% CI 0.22-0.78; P = 0.007), and reduced occurrence of reoperation events and amputations in isolated lower limb vascular trauma (weighted OR 0.27; 95% CI 0.14-0.52; P < 0.0001).ConclusionThere was a statistically significant correlation between the use of anticoagulation and vascular trauma outcome. A major limitation with many of the studies includes a lack of prospective analysis and therefore we recommend prospective studies to properly elucidate prognostic outcomes following use of these anticoagulants. Further studies need to be conducted to assess the effects of timing of anticoagulant delivery, dosages and severity of traumatic injury. Thus, this would prove to be very useful in the formation of guidelines.

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