Epidural catheters are associated with an increased risk of venous thromboembolism in trauma

Michael A. Vella, Ryan P. Dumas, Kristen Chreiman, Thomas Wasser, Brian P. Smith, Patrick M. Reilly, Mark J. Seamon, Adam Shiroff

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Little is known about the association between epidural catheters (EC) and venous thromboembolism (VTE) in trauma. We sought to study this association and hypothesized that trauma patients with EC were more likely to develop VTE. Using the Pennsylvania Trauma Outcomes Study (PTOS) registry, we identified all adult trauma patients (age ≥ 18) admitted for at least 2 days between 1/2013 and 12/2017. Baseline characteristics and outcome variables were compared between patients who underwent EC placement and those who did not. The primary outcome was development of VTE. 147,721 patients met inclusion criteria; 2247 (1.5%) developed a VTE. Patients were mostly white (85%), male (56%), with blunt trauma (94%). 776 (0.5%) had an EC placed. Patients who underwent EC placement were more likely to develop a VTE (2.8% vs. 1.5%, p = 0.003). After adjusting for covariates, patients with EC were 1.6 times more likely to develop VTE (95% CI 1.1–2.5). The overall rate of VTE was low and associated with the use of EC. Future work should focus on determining the underlying mechanisms.

Original languageEnglish (US)
Pages (from-to)420-425
Number of pages6
JournalJournal of Thrombosis and Thrombolysis
Volume49
Issue number3
DOIs
StatePublished - Apr 1 2020

Keywords

  • Deep vein thrombosis (DVT)
  • Epidural catheter
  • Pulmonary embolism (PE)
  • Trauma
  • Venous thromboembolism (VTE)

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Vella, M. A., Dumas, R. P., Chreiman, K., Wasser, T., Smith, B. P., Reilly, P. M., Seamon, M. J., & Shiroff, A. (2020). Epidural catheters are associated with an increased risk of venous thromboembolism in trauma. Journal of Thrombosis and Thrombolysis, 49(3), 420-425. https://doi.org/10.1007/s11239-019-02024-3