Predictors of early versus late timing of pulmonary embolus after traumatic injury

Scott C. Brakenridge, Seth M. Toomay, Jean L. Sheng, Larry M. Gentilello, Shahid Shafi

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objective: To identify risk factors predictive of pulmonary embolus (PE) timing after a traumatic injury. Methods: One hundred eight traumatic injury patients with a confirmed diagnosis of PE were classified as early PE (≤4 days, n = 54) or late PE (>4 days, n = 54). Independent predictors of early versus late PE were identified using multivariate logistic regression. Results: Half the PEs were diagnosed ≤4 days of injury. Only long bone fractures independently predicted early PE (odds ratio 2.8; 95% confidence interval, 1.17.1). Severe head injuries were associated with late PE (odds ratio 11.1; 95% confidence interval, 3.931). Established risk factors such as age did not affect timing. Conclusions: Half the PEs were diagnosed ≤4 days after injury. The risk of early PE appeared highest in patients with long bone fractures, and the benefits of immediate prophylaxis may outweigh risks. Patients with severe head injuries appear to have later PE events. Prospective interventional trials in these injury populations are needed.

Original languageEnglish (US)
Pages (from-to)209-215
Number of pages7
JournalAmerican journal of surgery
Volume201
Issue number2
DOIs
StatePublished - Feb 2011

Keywords

  • Injury
  • Pulmonary embolus
  • Trauma

ASJC Scopus subject areas

  • Surgery

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