Alicia A Heelan1, Mari Freedberg2, Ernest E Moore3, Barry K Platnick4, Fredric M Pieracci5, Mitchell J Cohen6, Ryan Lawless7, Eric M Campion8, Jamie J Coleman9, Melanie Hoehn10, Clay Cothren Burlew11. 1. University of Colorado School of Medicine, Department of Surgery, 12631 E. 17th Avenue, Room 5403, Mailstop C-302, Aurora, CO, 80045, USA. Electronic address: Alicia.heelangladden@cuanschutz.edu. 2. Saint Joseph Hospital- SCL Health, Department of Surgery, 1375 E 19th Ave, Denver, CO, 80218, USA. Electronic address: Mari.freedberg@sclhealth.org. 3. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Ernest.Moore@dhha.org. 4. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Barry.platnick@dhha.org. 5. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Fredric.pieracci@dhha.org. 6. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Mitchell.cohen@dhha.org. 7. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Ryan.lawless@dhha.org. 8. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Eric.Campion@dhha.org. 9. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Jamie.Coleman@dhha.org. 10. Denver Health Medical Center, Department of Surgery, University of Colorado School of Medicine, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: Melanie.hoehn@dhha.org. 11. Department of Surgery, Denver Health Medical Center, 777 Bannock Street, MC 0206, Denver, CO, 80204, USA. Electronic address: clay.cothren@dhha.org.
Abstract
BACKGROUND: Venous thromboembolism (VTE) in patients with major pelvic fractures who undergo preperitoneal pelvic packing (PPP) has not been investigated. We hypothesized that patients who undergo PPP are at high risk for VTE, thus early prophylactic anticoagulation and screening duplex are warranted. STUDY DESIGN: All patients requiring PPP from 2015 to 2019 were reviewed. Management and outcomes were analyzed. RESULTS: During the study period, 79 patients underwent PPP. Excluding the early deaths, 17 patients had deep venous thrombosis (DVT) and 6 had pulmonary emboli (PE); 4 patients had both DVT/PE. Overall mortality was 15%. Thirty-two patients underwent screening duplex within 72 h of admission and 10 were positive for DVT. CONCLUSION: Patients with complex pelvic trauma undergoing PPP have a 23% incidence of DVT and an additional 8% incidence of PE. 31% of screening ultrasounds are positive. The overall mortality was 15%. With a high incidence of VTE in this patient population, we recommend screening duplex ultrasounds.
BACKGROUND:Venous thromboembolism (VTE) in patients with major pelvic fractures who undergo preperitoneal pelvic packing (PPP) has not been investigated. We hypothesized that patients who undergo PPP are at high risk for VTE, thus early prophylactic anticoagulation and screening duplex are warranted. STUDY DESIGN: All patients requiring PPP from 2015 to 2019 were reviewed. Management and outcomes were analyzed. RESULTS: During the study period, 79 patients underwent PPP. Excluding the early deaths, 17 patients had deep venous thrombosis (DVT) and 6 had pulmonary emboli (PE); 4 patients had both DVT/PE. Overall mortality was 15%. Thirty-two patients underwent screening duplex within 72 h of admission and 10 were positive for DVT. CONCLUSION:Patients with complex pelvic trauma undergoing PPP have a 23% incidence of DVT and an additional 8% incidence of PE. 31% of screening ultrasounds are positive. The overall mortality was 15%. With a high incidence of VTE in this patient population, we recommend screening duplex ultrasounds.