Incidence of asymptomatic pulmonary embolism in moderately to severely injured trauma patients.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Schultz, DJ; Brasel, KJ; Washington, L; Goodman, LR; Quickel, RR; Lipchik, RJ; Clever, T; Weigelt, J

Published Date

  • April 2004

Published In

Volume / Issue

  • 56 / 4

Start / End Page

  • 727 - 731

PubMed ID

  • 15187734

Pubmed Central ID

  • 15187734

International Standard Serial Number (ISSN)

  • 0022-5282

Digital Object Identifier (DOI)

  • 10.1097/01.ta.0000119687.23542.ec

Language

  • eng

Conference Location

  • United States