Faculty Collaboration Database

Incidence of asymptomatic pulmonary embolism in moderately to severely injured trauma patients. J Trauma 2004 Apr;56(4):727-31; discussion 731-3

Date

06/10/2004

Pubmed ID

15187734

DOI

10.1097/01.ta.0000119687.23542.ec

Scopus ID

2-s2.0-11144356709 (requires institutional sign-in at Scopus site)   155 Citations

Abstract

BACKGROUND: Chest computed tomographic (CT) scanning is used frequently to evaluate symptomatic patients for pulmonary embolus (PE). The incidence of PE diagnosed by helical CT scanning in asymptomatic patients is unknown.

METHODS: Asymptomatic trauma patients with an Injury Severity Score > or = 9 were studied with contrast-enhanced helical CT images of the chest, pelvis, and lower extremities. Clot burden was assessed using an anatomic scoring system. Patients not receiving anticoagulation were followed.

RESULTS: Twenty-two of 90 patients had a PE. Four had major clot burden, including one patient with a saddle embolus. Risk factors for asymptomatic PE include age (odds ratio [OR], 1.04), head injury (OR, 6.78), chest injury (OR, 4.51), lower extremity injury (OR, 5.03), and transfusion (OR, 3.42). Thirty percent of patients receiving pharmacologic prophylaxis had a PE.

CONCLUSION: Asymptomatic PE occur in 24% of moderately to severely injured patients. Age, head, chest, and lower extremity injury are associated with an increased risk. Standard thromboembolic prophylaxis is not reliably protective.

Author List

Schultz DJ, Brasel KJ, Washington L, Goodman LR, Quickel RR, Lipchik RJ, Clever T, Weigelt J

Author

Randolph J. Lipchik MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Female
Humans
Injury Severity Score
Male
Prevalence
Prospective Studies
Pulmonary Embolism
Risk Factors
Tomography, Spiral Computed
Wounds and Injuries