Karcutskie CA, et al. - This study aimed to test the hypothesis that risk factors for pulmonary embolism (PE) vs deep venous thrombosis (DVT) are different after penetrating trauma. Researchers identified differences regarding risk factors for DVT and PE after blunt or penetrating trauma. Thereby suggesting that postinjury DVT and PE might represent independent thrombotic processes and that blunt or penetrating injury might evoke different compensatory responses.

Methods

• Researchers performed a retrospective review of 1137 adult trauma intensive care unit patients (1/2010-1/2015) receiving chemical and mechanical prophylaxis.
• Independent predictors of DVT and PE were identified with multivariate logistic regression.

Results

• DVT and PE rates were 7.7% vs 6.6% (p=0.520) and 2.5% vs 2.7% (p=0.822) for penetrating (n=324, 28.5%) vs blunt (n=813, 71.5%) trauma, respectively.
• Only 16.7% of the PE indicated a concomitant DVT, there appeared no difference in blunt vs penetrating trauma (13.6% vs 25.0%, p=0.460).
• In blunt trauma, independent predictors of DVT were length of stay (LOS) (OR: 1.01, 95% CI: 1.00-1.01), prolonged operation (2.48, 1.21-5.00), and Glasgow Coma scale score<8 (2.58, 1.13-5.89).
• In blunt trauma, the only independent predictor of PE was transfusion (2.62, 1.04-6.56).
• There appeared a negative correlation of abbreviated Injury Score (AIS) head>2 with PE (0.25, 0.07-0.88).
• Independent predictors of DVT in penetrating patients included LOS (1.01, 1.00-1.02), vascular injury (3.06, 1.11-8.41), and pelvic fracture (5.84, 1.51-22.51).
• In penetrating trauma, independent predictors of PE, however, included femoral line (6.93, 1.17-40.97) and AIS abdomen >2 (10.80, 1.24-94.24).