Characteristics of Mortalities related to Pulmonary Embolism following Multiple Trauma; a Brief Report
EMERGENCY ,
Vol. 6 No. 1 (2018),
19 Aban 2017
,
Page e48
https://doi.org/10.22037/emergency.v6i1.18900
Abstract
Introduction: Pulmonary embolism (PE) is introduced as the third major cause of death after trauma in those who survive more than 24 hours. This study aimed to describe the characteristics of mortalities due to trauma related PE in cases referred to the forensic medicine department.
Methods: The present cross sectional study was conducted on medical profiles of cadavers that were registered as trauma related mortality in the dissection department of the Forensic Medicine Organization, Tehran, Iran, during 2011 to 2016.
Results: The cause of death for 92 of the 10800 (0.85%) evaluated cadavers was diagnosed as trauma related PE. The mean age of these patients was 58.37 ± 19.39 years (66.3% male). Only 14 (15.2%) hospitalized patients had received anticoagulant agents. The most frequent trauma related PE mortality cases were male (p = 0.003) and aged > 55 years (p = 0.005), with trauma to death time of < 3 weeks (p = 0.004), lower limb injury (p = 0.003), car crash trauma mechanism (p = 0.003), and no anticoagulant prescribed (p = 0.001).
Conclusion: According to the results of the present study, the prevalence of trauma related PE mortality was 0.85%. It seems that, having a clear anticoagulation therapy protocol in trauma centers could be helpful in decreasing the prevalence of traumatic thromboembolism and its’ related mortality.
- Venous Thromboembolism
- multiple trauma
- Pulmonary Embolism
- mortality
- forensic medicine
References
McLaughlin DF, Wade CE, Champion HR, Salinas J, Holcomb JB. Thromboembolic complications following trauma. Transfusion. 2009;49(s5):256S-63S.
Knudson MM, Ikossi DG. Venous thromboembolism after trauma. Curr Opin Crit Care. 2004;10(6):539-48.
Golin V, Sprovieri SRS, Bedrikow R, Salles MJC. Pulmonary thromboembolism: retrospective study of necropsies performed over 24 years in a university hospital in Brazil. Sao Paulo Medical Journal. 2002;120(4):105-8.
Anderson FA, Spencer FA. Risk factors for venous thromboembolism. Circulation. 2003;107(23 suppl 1):I-9-I-16.
Knudson MM, Ikossi DG, Khaw L, Morabito D, Speetzen LS. Thromboembolism after trauma: an analysis of 1602 episodes from the American College of Surgeons National Trauma Data Bank. Annals of surgery. 2004;240(3):490.
Nutescu EA. Assessing, preventing, and treating venous thromboembolism: evidence-based approaches. American Journal of Health-System Pharmacy. 2007;64(11 Supplement 7):S5-S13.
Mostafazadeh B, Ahmad EFS, Zavvareh HT, Gharadaghi J, Saleki S. Prevalence of pulmonary thromboemboli among referred cadavers having hospitalization records to Tehran Legal Medicine Center. Journal of forensic and legal medicine. 2008;15(5):322-4.
Ho KM, Burrell M, Rao S, Baker R. Incidence and risk factors for fatal pulmonary embolism after major trauma: a nested cohort study. British journal of anaesthesia. 2010;105(5):596-602.
Echeverria RF, Baitello AL, de Godoy JMP, Espada PC, Morioka RY. Prevalence of death due to pulmonary embolism after trauma. Lung India: official organ of Indian Chest Society. 2010;27(2):72.
Alikhan R, Peters F, Wilmott R, Cohen A. Fatal pulmonary embolism in hospitalised patients: a necropsy review. Journal of clinical pathology. 2004;57(12):1254-7.
Lu Y, Ma B, Guo R, Wang Y, Zhang J, Wu Y, et al. Deep vein thrombosis in trauma: a prospective study of lower limb orthopedic trauma patients in Tianjin Hospital, China. International angiology. 2007;26(2):165.
Praeger AJ, Westbrook AJ, Nichol AD, Wijemunige R, Davies AR, Lyon SM, et al. Deep vein thrombosis and pulmonary embolus in patients with traumatic brain injury: a prospective observational study. Critical Care and Resuscitation. 2012;14(1):10.
Yakar A, Yakar F, Ziyade N, Yıldız M, Üzün I. Fatal pulmonary thromboembolism. European review for medical and pharmacological sciences. 2016;20(7):1323-6.
- Abstract Viewed: 644 times
- PDF Downloaded: 452 times