Abstract
BackgroundThis study was performed to determine whether trauma patients are at an increased risk of developing deep venous thrombosis (DVT) within the first 48 hours of hospitalization.Materials and methodsA retrospective review was performed using a prospectively maintained database of patients admitted to a trauma center during a five-year time period. Patients hospitalized for greater than 48 hours who received a screening venous duplex for DVT were included in the study.ResultsThere were 1067 venous duplex scans obtained, 689 (64.5%) within the first 48 hours of admission (early DVT group), 378 (35.4%) after the first 48 hours (late DVT group). Only 142 (13.2%) patients had a positive duplex scan for DVT, 55 (early group), 87 (late group). Comorbid conditions of congestive heart failure (P = 0.02), pelvic fractures (P = 0.04), and a lower initial systolic blood pressure on presentation (p = 0.04) were associated with early DVT. Head trauma (P < 0.01), mechanical ventilation (P < 0.001), and transfusion of blood products (P < 0.001), were predictors of DVT in the late group.ConclusionsTrauma patients are at an increased risk of developing venous thrombosis early in the hospital course due to comorbidities associated with trauma. Whereas, venous thrombosis in trauma patients diagnosed after the first 48 hours of hospitalization appears to be associated with prolonged patient immobility.
Highlights
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in trauma patients and pulmonary embolism represents one of the most common causes of death in those surviving the first 24 hours of hospitalization [1]
Trauma patients are at an increased risk of developing venous thrombosis early in the hospital course due to comorbidities associated with trauma
Venous thrombosis in trauma patients diagnosed after the first 48 hours of hospitalization appears to be associated with prolonged patient immobility
Summary
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in trauma patients and pulmonary embolism represents one of the most common causes of death in those surviving the first 24 hours of hospitalization [1]. Literature suggests the incidence of VTE in high-risk trauma patients without prophylaxis is 14% to 59% with rates of 3.6% to 33% for those patients on prophylaxis [2,3,4,5]. Only those patients clinically suspected of having deep venous thrombosis (DVT) underwent venous duplex ultrasound (VDU) imaging. This study was performed to determine whether trauma patients are at an increased risk of developing deep venous thrombosis (DVT) within the first 48 hours of hospitalization
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