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
Rok vydání: 1997
Předmět:
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