Orthopedic Trauma Surgery Team at Inova Fairfax Medical Campus Participates in Highly Successful Blood Clot Prevention Study

Falls Church, VA – Inova Fairfax Medical Campus’s orthopedic trauma surgery team enrolled a significant number of patients in the landmark “PREVENT CLOT” randomized controlled trial published last week in the New England Journal of Medicine. The study was a monumental effort led by researchers at the University of Maryland Shock Trauma Center and the Major Extremity Trauma Research Consortium (METRC) that included 21 North American trauma centers and required the close collaboration of trauma surgeons and orthopedic surgeons.

As part of this study – the most extensive orthopedic trauma study ever conducted – 12,211 patients who underwent surgical repair of a leg fracture or arm fracture, or any pelvis fracture treatment between 2017 and 2021 were randomly assigned to take an injectable low molecular weight heparin (enoxaparin 30 mg) or a “baby” aspirin (81 mg) by mouth twice daily. Aspirin was found to be as effective as low molecular weight heparin in preventing death (less than 1% in both groups) and blood clots in the lungs (1.5% in both groups). The rate of blood clots (deep vein thromboses, or DVTs) in the legs was 0.8% higher in the aspirin group compared to the enoxaparin group. This was primarily driven by less clinically relevant DVTs of the lower legs, which often do not require treatment.

The $11.7 million study was funded by the Patient-Centered Outcomes Research Institute. Current guidelines recommend injectable low molecular weight heparin to prevent blood clots in orthopedic trauma patients with broken bones. Greg Gaski, MD, principal site investigator and Director of Research for the Orthopedic Trauma Division at Inova Fairfax Medical Campus, commented, “The results of this trial may challenge our current guidelines and likely influence a new standard of care for blood clot prevention. Patients prefer medication that can be taken by mouth compared to more painful and costly skin injections.”

Principal site investigator Robert Hymes, MD, Chairman of the Department of Orthopedic Surgery at Inova Fairfax Medical Center and Chief of Orthopedic Trauma for the Inova Health System, stated, “It’s exciting to participate in clinical investigations that improve the care of patients in real time.  From the advanced practice providers, residents and research coordinators to the orthopedic trauma surgeons, this was a true team effort. We are all honored to have played a role in ‘PREVENT CLOT.’”

Researchers at Inova are grateful to the numerous patients of Northern Virginia who willingly participated in this practice-changing investigation. More than 1 million Americans are hospitalized every year with pelvis, arm and leg fractures. This improvement in care will benefit millions of orthopedic trauma patients in our region and nationwide.

About the “PREVENT CLOT” study:

Inova team:
Principial site investigators: Robert Hymes, MD, and Greg Gaski, MD

Additional site investigators: Michael Holzman, MD; Jeff Schulman, MD; Stephen Malekzadeh, MD; Cary Schwartzbach, MD; Lolita Ramsey, PhD; Stacy Niederman, PA; Anna Clinton, NP; Kirby Holland, PA; Kathryn Battle, PA; and Elizabeth Davies, PA

New England Journal of Medicine article

New England Journal of Medicine summary

Video Summary

About Inova

Inova is Northern Virginia’s leading nonprofit healthcare provider. Our mission is to provide world-class healthcare – every time, every touch – to each person in every community we have the privilege to serve. Inova’s 20,000 team members provide more than 2 million patient visits each year through an integrated network of hospitals, primary and specialty care practices, emergency and urgent care centers, outpatient services, and destination institutes. 

Inova’s five hospitals are consistently recognized by the Centers for Medicare and Medicaid Services, U.S. News & World Report Best Hospitals, and Leapfrog Hospital Safety Grades for excellence in healthcare.

Inova is home to Northern Virginia’s only Level 1 Trauma Center and Level 4 Neonatal Intensive Care Unit. Its hospitals have a total of 1,936 licensed beds. More information about Inova can be found at inova.org.

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