+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Venous thromboembolism after severe trauma: incidence, risk factors and outcome



Venous thromboembolism after severe trauma: incidence, risk factors and outcome



Injury 41(1): 97-101



Venous thromboembolic events (VTEs) are common life-threatening complications after trauma, but epidemiology and reported risk factors still vary. The purpose of this investigation was to determine the incidence of VTEs among hospitalised trauma patients, to identify potential risk factors and to assess whether their presence was associated with: (a) the magnitude and pattern of injury, (b) therapeutic interventions and (c) outcome, all by using a large population-based registry. Patient data from the Trauma Registry of the German Society for Trauma Surgery (TR-DGU) including datasets from more than 35,000 trauma patients were screened for all clinically relevant VTEs, i.e. deep vein thrombosis (DVT) and pulmonary embolism (PE). A total of 7937 patients were identified for further investigation and multivariate logistic regression analyses were performed to assess potential risk factors for VTEs and to evaluate the effect of VTEs on outcome. One hundred forty-six of 7937 patients developed clinically relevant VTEs during post-traumatic hospitalisation corresponding to an overall incidence rate of 1.8%. Two-thirds (97/146) of all VTEs occurred during the first 3 weeks after admission. At the time point of the event 118/146 (80.8%) patients were under either mechanical or chemical prophylaxis. Multivariate analysis with VTE as dependent variable identified injury severity score, the number of operative procedures, pelvic injury (abbreviated injury scale > or = 2) and concomitant diseases (i.e. diabetes, renal failure, malignancies and congenital or acquired coagulation disorders) as independent risk factors. The presence of VTEs was associated with higher frequencies of sepsis (25% vs. 9.1%), single (63.6% vs. 41.3%) and multiple organ failure (49% vs. 25%) and prolonged in-hospital length of stay (52+/-34 days vs. 29+/-30 days; all p<0.001). The mortality in the VTE group totaled 13.7% vs. 7.4% in the non-VTE group (p=0.004). The presence of PE was associated with a mortality rate of 25.7%. The adjusted odds ratio of post-traumatic VTEs for hospital mortality was 2.08 (CI95 1.15-3.78; p=0.016). The occurrence of clinically apparent VTEs during post-traumatic hospitalisation is low but associated with increased morbidity and mortality. Conclusions about the effectiveness of different thromboprophylactic measures could not be drawn, since detailed information was not recorded. However, 80.8% of VTE patients had received thromboprophylaxis at the time point of the event.

(PDF emailed within 0-6 h: $19.90)

Accession: 056859578

Download citation: RISBibTeXText

PMID: 19608183

DOI: 10.1016/j.injury.2009.06.010


Related references

Incidence and risk factors for venous thromboembolism in critically ill children after trauma. Journal of Trauma 68(1): 52-56, 2010

Symptomatic venous thromboembolism in Asian major trauma patients: incidence, presentation and risk factors. European Journal of Trauma and Emergency Surgery 39(5): 495-500, 2013

Venous thromboembolism and bleeding in critically ill patients with severe renal insufficiency receiving dalteparin thromboprophylaxis: prevalence, incidence and risk factors. Critical Care 12(2): R32-R32, 2008

Risk Factors for Venous Thromboembolism in Pediatric Trauma Patients and Validation of a Novel Scoring System: The Risk of Clots in Kids With Trauma Score. Pediatric Critical Care Medicine 17(5): 391-399, 2017

Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Archives of Internal Medicine 162(10): 1182-1189, 2002

Cardiovascular risk factors and venous thromboembolism incidence The Longitudinal Investigation of Thromboembolism Etiology study. Circulation 102(18 Supplement): II 861, October 31, 2000

ABO blood group, other risk factors and incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology (LITE). Journal of Thrombosis and Haemostasis 5(7): 1455-1461, 2007

Risk factors for venous thromboembolism in pediatric trauma. Journal of Trauma 52(5): 922-927, 2002

Risk factors for venous thromboembolism after pediatric trauma. Journal of Pediatric Surgery 51(1): 168-171, 2016

Incidence and risk factors for venous thromboembolism. La Revue du Praticien 57(7): 711-3, 716, 719-20, 2007

Venous thromboembolism risk factors in a pediatric trauma population. Pediatric Surgery International: -, 2018

Venous thromboembolism in trauma patients: Standardized risk factors. Journal of Vascular Surgery 28(2): 250-259, 1998

Postpartum venous thromboembolism: incidence and risk factors. Obstetrics and Gynecology 124(4): 837-838, 2015

Venous thromboembolism--incidence and risk factors in Oslo. Tidsskrift for den Norske Laegeforening 118(25): 3934-3938, 1998

Risk factors associated with venous thromboembolism in isolated blunt chest trauma. American Surgeon 79(5): 502-505, 2013