Journal article
Risk of pulmonary embolism in trauma patients: Not all created equal
Surgery, v 154(4), pp 810-815
01 Oct 2013
PMID: 24074419
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Patients with traumatic brain injury (TBI) are assumed to be at an increased risk for pulmonary embolism (PE). Delay in the initiation of chemoprophylaxis and prophylactic placement of inferior vena cava filters have been advocated by some because of concerns for increased intracranial hemorrhage in the presence of prophylactic anticoagulation. We hypothesized that patients with isolated TBI would not be at increased risk for the development of PE compared with the general trauma population.
Patients from the National Trauma Data Bank from the year 2008 were analyzed. Patient demographics, Injury Severity Score, and the prevalence of deep-vein thrombosis and PE were extracted. Studied injuries were assigned to six categories: thorax, abdominal solid organs, pelvic fracture, lower extremity fracture, spine fracture, and TBI.
Of a total of 627,775 injured patients, 2,182 (0.35%) had a documented PE. The prevalence of PE in patients with isolated TBI, lower extremity, pelvic fracture, liver and/or spleen, thorax, spine, multiple injuries, and none of the studied injuries were 0.25%, 0.36%, 0.35%, 0.37%, 0.52%, 0.37%, 1.1%, and 0.12%, respectively. Using an age-, sex- and race-adjusted multivariable logistic regression model and controlling for interaction between inferior vena cava filters and injury types, we found that isolated TBI was not associated with PE.
Isolated TBI does not appear to be associated with an increased incidence of PE compared with other injuries. Patients with isolated TBI may not require early aggressive prophylaxis as is the standard for other high-risk groups.
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Details
- Title
- Risk of pulmonary embolism in trauma patients: Not all created equal
- Creators
- Elan Jeremitsky - Allegheny General HospitalNatasha St GermainAmy H Kao - Allegheny General HospitalAdrian W Ong - Reading HospitalR Stephen Smith - University of South Carolina
- Publication Details
- Surgery, v 154(4), pp 810-815
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000325509700040
- Scopus ID
- 2-s2.0-84884866698
- Other Identifier
- 991022020738104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery