Pulmonary embolism following complex trauma: UK MTC observational study

Emergency Medicine Journal - Tập 36 Số 10 - Trang 608-612 - 2019
Thomas E. Glover1,2, Joanna E Sumpter1,2, Ari Ercole1,2,3, Virginia Newcombe1,2,3, Andrea Glotta1,2, Andrew Carrothers4,5, David Menon1,2,3, Rebecca A. O’Leary1,2
1Cambridge University Hospitals
2Neurosciences and Trauma Critical Care Unit
3University Division of Anaesthesia, Department of Medicine
4Cambridge University Hospitals NHS Foundation Trust;
5Orthopaedic Trauma Unit

Tóm tắt

ObjectivesTo describe the incidence of pulmonary embolism (PE) in a critically ill UK major trauma centre (MTC) patient cohort.MethodsA retrospective, multidataset descriptive study of all trauma patients requiring admission to level 2 or 3 care in the East of England MTC from 1 November 2014 to 1 May 2017. Data describing demographics, the nature and extent of injuries, process of care, timing of PE prophylaxis, tranexamic acid (TXA) administration and CT scanner type were extracted from the Trauma Audit and Research Network database and hospital electronic records. PE presentation was categorised as immediate (diagnosed on initial trauma scan), early (within 72 hours of admission but not present initially) and late (diagnosed after 72 hours).ResultsOf the 2746 trauma patients, 1039 were identified as being admitted to level 2 or 3 care. Forty-eight patients (4.6%) were diagnosed with PE during admission with 14 immediate PEs (1.3%). Of 32.1% patients given TXA, 6.3% developed PE compared with 3.8% without TXA (p=0.08).ConclusionThis is the largest study of the incidence of PE in UK MTC patients and describes the greatest number of immediate PEs in a civilian complex trauma population to date. Immediate PEs are a rare phenomenon whose clinical importance remains unclear. Tranexamic acid was not significantly associated with an increase in PE in this population following its introduction into the UK trauma care system.

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Emergency Medicine Journal

Tập 36 Số 10

608-612

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