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dc.contributor.authorGlover, Thomas Een
dc.contributor.authorSumpter, Joanna Een
dc.contributor.authorErcole, Arien
dc.contributor.authorNewcombe, Virginiaen
dc.contributor.authorLavinio, Andreaen
dc.contributor.authorCarrothers, Andrew Den
dc.contributor.authorMenon, Daviden
dc.contributor.authorO'Leary, Ronanen
dc.date.accessioned2019-08-19T23:30:19Z
dc.date.available2019-08-19T23:30:19Z
dc.date.issued2019-10en
dc.identifier.issn1472-0205
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/295958
dc.description.abstractPurpose: 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.
dc.format.mediumPrinten
dc.languageengen
dc.publisherBMJ Publishing Group
dc.rightsAll rights reserved
dc.subjectHumansen
dc.subjectPulmonary Embolismen
dc.subjectMultiple Traumaen
dc.subjectIncidenceen
dc.subjectRetrospective Studiesen
dc.subjectTime Factorsen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAged, 80 and overen
dc.subjectMiddle Ageden
dc.subjectTrauma Centersen
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectYoung Adulten
dc.subjectDatasets as Topicen
dc.subjectUnited Kingdomen
dc.titlePulmonary embolism following complex trauma: UK MTC observational study.en
dc.typeArticle
prism.endingPage612
prism.issueIdentifier10en
prism.publicationDate2019en
prism.publicationNameEmergency medicine journal : EMJen
prism.startingPage608
prism.volume36en
dc.identifier.doi10.17863/CAM.43006
dcterms.dateAccepted2019-08-05en
rioxxterms.versionofrecord10.1136/emermed-2018-208372en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-10en
dc.contributor.orcidErcole, Ari [0000-0001-8350-8093]
dc.contributor.orcidNewcombe, Virginia [0000-0001-6044-9035]
dc.contributor.orcidMenon, David [0000-0002-3228-9692]
dc.contributor.orcidO'Leary, Ronan [0000-0002-8903-4295]
dc.identifier.eissn1472-0213
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idAcademy of Medical Sciences (unknown)
cam.orpheus.successThu Jan 30 10:40:35 GMT 2020 - Embargo updated*
rioxxterms.freetoread.startdate2019-10-31


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