Timing of the Occurrence of Pulmonary Embolism in Trauma Patients
Autor: | Robert J. O'Malley, John T. Cornelius, Eric J. Kraut, John T. Owings, Felix D. Battistella |
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Rok vydání: | 1997 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.diagnostic_test Ventilation/perfusion scan business.industry Respiratory disease Trauma center Autopsy Retrospective cohort study Middle Aged medicine.disease Pulmonary embolism Surgery Fraction of inspired oxygen medicine Humans Wounds and Injuries Female Risk factor Pulmonary Embolism business Retrospective Studies |
Zdroj: | Archives of Surgery. 132:862 |
ISSN: | 0004-0010 |
DOI: | 10.1001/archsurg.1997.01430320064010 |
Popis: | 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 PaO 2 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. Arch Surg. 1997;132:862-867 |
Databáze: | OpenAIRE |
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