| Pulmonary embolism and deep venous thrombosis in trauma: are they related? | |
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MedLine Citation:
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PMID: 19841360 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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HYPOTHESIS: Pulmonary embolism (PE) and deep venous thrombosis (DVT) in trauma are related. DESIGN: Retrospective review of medical records. SETTING: Academic level I trauma center. PATIENTS: Trauma patients who underwent computed tomographic pulmonary angiography (CTPA) with computed tomographic venography (CTV) of the pelvic and proximal lower extremity veins over a 3-year period (January 1, 2004, to December 31, 2006) were reviewed. Data on demographics, injury type and severity, imaging findings, hospital length of stay, and mortality were collected. MAIN OUTCOME MEASURES: Pulmonary embolism and DVT. RESULTS: Among 247 trauma patients undergoing CTPA/CTV, PE was diagnosed in 46 (19%) and DVT in 18 (7%). Eighteen PEs were central (main or lobar pulmonary arteries), and 28 PEs were peripheral (segmental or subsegmental branches). Pulmonary embolism occurred within the first week of injury in two-thirds of patients. Seven patients with PE (4 femoral, 2 popliteal, and 1 iliac) had DVT. Pulmonary embolism was central in 5 patients and peripheral in 2 patients. No significant differences were noted in any of the examined variables between patients with PE having DVT and those not having DVT. CONCLUSIONS: Few patients with PE have DVT of the pelvic or proximal lower extremity veins. Pulmonary embolism may not originate from these veins, as commonly believed, but instead may occur de novo in the lungs. These findings have implications for thromboprophylaxis and, particularly, the value of vena cava filters. |
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Authors:
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George C Velmahos; Konstantinos Spaniolas; Malek Tabbara; Hani H Abujudeh; Marc de Moya; Alice Gervasini; Hasan B Alam |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 144 ISSN: 1538-3644 ISO Abbreviation: Arch Surg Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-20 Completed Date: 2009-12-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
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Languages: eng Pagination: 928-32 Citation Subset: AIM; IM |
Affiliation:
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Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge St, Ste 810, Boston, MA 02114, USA. gvelmahos@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anticoagulants / therapeutic use Cohort Studies Female Humans Male Middle Aged Pulmonary Embolism / diagnosis, epidemiology*, therapy Retrospective Studies Risk Factors Severity of Illness Index Tomography, X-Ray Computed Vena Cava Filters Venous Thrombosis / diagnosis, epidemiology*, therapy Wounds and Injuries / complications*, radiography, therapy |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
| Comments/Corrections | |
Comment In:
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Arch Surg. 2009 Oct;144(10):932
[PMID:
19852101
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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