| Incidence of asymptomatic pulmonary embolism in moderately to severely injured trauma patients. | |
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MedLine Citation:
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PMID: 15187734 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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David J Schultz; Karen J Brasel; Lacey Washington; Lawrence R Goodman; Robert R Quickel; Randolph J Lipchik; Todd Clever; John Weigelt |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of trauma Volume: 56 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 2004 Apr |
Date Detail:
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Created Date: 2004-06-10 Completed Date: 2004-06-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 727-31; discussion 731-3 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Humans Injury Severity Score Male Prevalence Prospective Studies Pulmonary Embolism / diagnosis, epidemiology, etiology* Risk Factors Tomography, Spiral Computed Wounds and Injuries / classification, complications* |
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