OBJECTIVE: To determine how soon after trauma pulmonary embolism (PE) occurs and if there is an association between the duration of this interval and mortality. DESIGN: Retrospective case series. PATIENTS: All patients admitted to our trauma service with established PE based on high probability findings on ventilation perfusion scan, positive results on a pulmonary arteriogram, or autopsy from July 1, 1990, to September 30, 1995. MAIN OUTCOME MEASURE: Time interval between injury and PE. SETTING: Level I university trauma center. RESULTS: Of 18,255 trauma patients identified, 63 met our criteria for PE (30 using a pulmonary arteriogram; 26, a ventilation perfusion scan; and 7, autopsy). Four patients (6%) had a documented PE on day 1 following injury. Mortality was not correlated with the interval between injury and PE. Of the 63 patients, 58 (92%) had 1 or more established risk factors for thromboembolism. The ratio of PaO2 to fraction of inspired oxygen was the only factor predictive of mortality (P = .02, logistic regression analysis). CONCLUSIONS: Pulmonary embolism occurs in the immediate period following injury. Aggressive workup in patients with signs consistent with PE should be instituted promptly. Trauma patients who have at least 1 risk factor for thromboembolism should receive prophylaxis as soon after injury as possible.
OBJECTIVE: To determine how soon after trauma pulmonary embolism (PE) occurs and if there is an association between the duration of this interval and mortality. DESIGN: Retrospective case series. PATIENTS: All patients admitted to our trauma service with established PE based on high probability findings on ventilation perfusion scan, positive results on a pulmonary arteriogram, or autopsy from July 1, 1990, to September 30, 1995. MAIN OUTCOME MEASURE: Time interval between injury and PE. SETTING: Level I university trauma center. RESULTS: Of 18,255 traumapatients identified, 63 met our criteria for PE (30 using a pulmonary arteriogram; 26, a ventilation perfusion scan; and 7, autopsy). Four patients (6%) had a documented PE on day 1 following injury. Mortality was not correlated with the interval between injury and PE. Of the 63 patients, 58 (92%) had 1 or more established risk factors for thromboembolism. The ratio of PaO2 to fraction of inspired oxygen was the only factor predictive of mortality (P = .02, logistic regression analysis). CONCLUSIONS:Pulmonary embolism occurs in the immediate period following injury. Aggressive workup in patients with signs consistent with PE should be instituted promptly. Traumapatients who have at least 1 risk factor for thromboembolism should receive prophylaxis as soon after injury as possible.
Authors: Benjamin N Jacobs; Anne H Cain-Nielsen; Jill L Jakubus; Judy N Mikhail; John J Fath; Scott E Regenbogen; Mark R Hemmila Journal: J Trauma Acute Care Surg Date: 2017-07 Impact factor: 3.313
Authors: Brandon C Chapman; Ernest E Moore; Carlton Barnett; Robert T Stovall; Walter L Biffl; Clay C Burlew; Denis D Bensard; Gregory J Jurkovich; Fredric M Pieracci Journal: Am J Surg Date: 2013-10-07 Impact factor: 2.565
Authors: Todd A Miano; Adam Cuker; Jason D Christie; Niels Martin; Brian Smith; Amy T Makley; Wensheng Guo; Sean Hennessy Journal: Chest Date: 2017-08-18 Impact factor: 9.410
Authors: Cameron C Trenor; Richard J Chung; Alan D Michelson; Ellis J Neufeld; Catherine M Gordon; Marc R Laufer; S Jean Emans Journal: Pediatrics Date: 2011-01-03 Impact factor: 7.124
Authors: Joseph Cuschieri; Brad Freeman; Grant O'Keefe; Brian G Harbrecht; Paul Bankey; Jeffrey L Johnson; Joseph P Minei; Jason Sperry; Michael West; Avery Nathens; Ernest E Moore; Ronald V Maier Journal: J Trauma Date: 2008-10
Authors: Paul T. Engels; Heather Thomas; Angela Coates; Husham Bakry; Abdulaziz Alali; Ahmad AlGhambdi; Ahmed Al-Jabri; Ahmed Bugshan Journal: Can J Surg Date: 2019-12-01 Impact factor: 2.089