Premium
Pulmonary embolism and the use of vena cava filters after major trauma
Author(s) -
Batty Lachlan M.,
Lyon Stuart M.,
Dowrick Adam S.,
Bailey Michael,
Mahar Patrick D.,
Liew Susan M.
Publication year - 2012
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2012.06192.x
Subject(s) - medicine , pulmonary embolism , injury severity score , logistic regression , incidence (geometry) , blunt trauma , surgery , blunt , poison control , injury prevention , emergency medicine , physics , optics
Background Major trauma patients are at significant risk of developing pulmonary embolism ( PE ). We aimed to (i) analyse the current incidence and timing of PE after injury; (ii) identify risk factors that predispose major trauma patients to the occurrence of PE; and (iii) describe the use of vena cava filters ( VCFs ) following major trauma. Methods Prospectively collected data from T he A lfred H ospital's T rauma R egistry were used to identify all major trauma patients admitted over a 7‐year period. A multivariable logistic regression model was used to identify factors associated with the occurrence of PE . A similar model was developed to identify factors associated with the use of VCFs inserted at the discretion of the treating clinician. Results A total of 6344 major trauma patients were treated during this period, with 73.2% male, mean age of 44.2, 90.2% with a blunt mechanism of injury and mean injury severity score of 24.3. Prophylactic VCFs were inserted in 511 patients (8.1%), with a mean time to insertion of 3.6 days after injury. There were 45 PE , 2 of which were fatal. The mean time to PE was 12 days post‐injury. Three variables were independently associated with the occurrence of PE : the absence of a VCF ; number of injuries to the lower limb; and central venous catheterization. Conclusion The PE rate was 0.71%. Lower limb injuries and central venous catheterization are independently associated with a higher risk of PE after major trauma and VCFs are associated with a reduced risk.