Pulmonary embolism following complex trauma: UK MTC observational study.
Glover, Thomas E
Sumpter, Joanna E
Carrothers, Andrew D
Emergency medicine journal : EMJ
BMJ Publishing Group
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Glover, T. E., Sumpter, J. E., Ercole, A., Newcombe, V., Lavinio, A., Carrothers, A. D., Menon, D., & et al. (2019). Pulmonary embolism following complex trauma: UK MTC observational study.. Emergency medicine journal : EMJ, 36 (10), 608-612. https://doi.org/10.1136/emermed-2018-208372
Purpose: To describe the natural history of pulmonary embolism in a critically ill UK major trauma centre (MTC) patient cohort. Methods: A retrospective study of all critically ill trauma patients admitted to the East of England MTC using the Trauma and Audit Research Network (TARN) database, electronic medical records, and our Picture Archiving and Communication System (PACS) was conducted. Data describing demographics, the nature and extent of injuries, process of care, timing of PE prophylaxis and tranexamic acid (TXA) administration and CT scanner type were collected. PE timing was divided into immediate (diagnosed on initial trauma scan), early (within 72 hours of admission but not present initially) and late (diagnosed after 72 hours). Data were analysed using standard statistical tests. Results: 1039 (of 2746) patients were admitted to a critical care environment at the East of England MTC from 1st November 2014 to 1st May 2017. 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 (p = 0.08). There was no significant difference in detection of sub-segmental PE (SSPE) in 64-slice and 128-slice CT scanners (p = 0.81). Conclusions: This is the largest study of the incidence of PE in UK MTC patients and describes the greatest number of immediate PEs in a civilian trauma population to date. Immediate PEs are a rare phenomenon whose clinical importance remains unclear. Tranexamic acid was not associated with a significant increase in PE incidence following its introduction into the UK trauma care system. Increasing CT scanner density from 64 to 128 rows does not appear to increase SSPE detection.
Humans, Pulmonary Embolism, Multiple Trauma, Incidence, Retrospective Studies, Time Factors, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Trauma Centers, Female, Male, Young Adult, Datasets as Topic, United Kingdom
Academy of Medical Sciences (unknown)
External DOI: https://doi.org/10.1136/emermed-2018-208372
This record's URL: https://www.repository.cam.ac.uk/handle/1810/295958
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