1. Worth looking! venous thromboembolism in patients who undergo preperitoneal pelvic packing warrants screening duplex.
- Author
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Heelan AA, Freedberg M, Moore EE, Platnick BK, Pieracci FM, Cohen MJ, Lawless R, Campion EM, Coleman JJ, Hoehn M, and Burlew CC
- Subjects
- Female, Hemorrhage mortality, Humans, Injury Severity Score, Male, Middle Aged, Pulmonary Embolism mortality, Risk Factors, Venous Thromboembolism mortality, Fractures, Bone complications, Hemorrhage prevention & control, Hemostatic Techniques adverse effects, Pelvic Bones injuries, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism etiology, Ultrasonography, Doppler, Duplex, Venous Thromboembolism diagnostic imaging, Venous Thromboembolism etiology
- Abstract
Background: Venous thromboembolism (VTE) in patients with major pelvic fractures who undergo preperitoneal pelvic packing (PPP) has not been investigated. We hypothesized that patients who undergo PPP are at high risk for VTE, thus early prophylactic anticoagulation and screening duplex are warranted., Study Design: All patients requiring PPP from 2015 to 2019 were reviewed. Management and outcomes were analyzed., Results: During the study period, 79 patients underwent PPP. Excluding the early deaths, 17 patients had deep venous thrombosis (DVT) and 6 had pulmonary emboli (PE); 4 patients had both DVT/PE. Overall mortality was 15%. Thirty-two patients underwent screening duplex within 72 h of admission and 10 were positive for DVT., Conclusion: Patients with complex pelvic trauma undergoing PPP have a 23% incidence of DVT and an additional 8% incidence of PE. 31% of screening ultrasounds are positive. The overall mortality was 15%. With a high incidence of VTE in this patient population, we recommend screening duplex ultrasounds., (Copyright © 2020. Published by Elsevier Inc.)
- Published
- 2020
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