Thromboembolic Complications in Trauma Patients

2004 ◽  
pp. 525-535
Author(s):  
M. Margaret Knudson
Keyword(s):  
Trauma Patients ◽  
Thromboembolic Complications

scholarly journals Thromboembolic complications after spinal surgery in trauma patients

2006 ◽  
Vol 77 (5) ◽  
pp. 755-760 ◽  
Author(s):  
Patrick Platzer ◽  
Gerhild Thalhammer ◽  
Manuela Jaindl ◽  
Alexandra Obradovic ◽  
Thomas Benesch ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Trauma Patients ◽  
Thromboembolic Complications

Generation of Tissue Factor by Patient Monocytes: Correlation to Thromboembolic Complications

1981 ◽  
Vol 46 (02) ◽  
pp. 489-495 ◽  
Author(s):  
Carol L Miller ◽  
Charles Graziano ◽  
Robert C Lim ◽  
Milly Chin
Keyword(s):  
Tissue Factor ◽  
Mononuclear Cells ◽  
Trauma Patients ◽  
Thromboembolic Complications ◽  
Post Injury ◽  
Catabolic Rate ◽  
Normal Individuals ◽  
Tissue Trauma ◽  
Pathological Consequence ◽  
Severe Soft Tissue

SummaryThromboembolic complications are often a common pathological consequence of severe soft tissue trauma. Recent demonstration that monocytes (MØ) produce tissue factor (TF) has led to the suggestion that these TF producing MØ might play a role in coagulopathy. We have previously demonstrated that trauma patients with splenectomy develop aberrant monocyte function and this patient group is also known to be at high risk of hypercoagulability episodes. This paper is an intial report on the use of MØ TF as an indicator of and/or a correlate to clotting episodes. Monocytes isolated from the Ficoll-Hypaque purified mononuclear cells of 46 normal individuals, 17 trauma patients and 6 surgical controls were assayed at 3 day post-injury intervals for their levels of TF activity. Changes in monocyte TF activity were correlated to increases in the fractional catabolic rate (FCR) of 125I-fibrinogen. Trauma patients were retrospectively divided into those whose FCR was elevated to a level indicative of coagulopathy and those whose FCR levels were not associated with coagulation abnormalites. All trauma patients who exhibited significantly increased FCR experienced thromboembolic episodes and had monocytes whose TF activity was increased an average of 300% (X = 47 units vs X = 12 units) over surgical controls. These increases in monocyte TF activity occrured at 6-13 days post injury and preceded clinical manifestation of coagulopathy by 4-6 days. The increased monocyte TF activity demonstrated in this study was significantly correlated to detection of pathologically increased FCR (Rs = 0.850) and compared to other indices of hypercoagulability.

scholarly journals Lower Mortality and Morbidity With Low Molecular Weight Heparin for Venous Thromboembolic Event Prophylaxis in Spine Trauma

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Emily K Chapman ◽  
Sean N Neifert ◽  
Robert J Rothrock ◽  
Frank Yuk ◽  
Ian T McNeill ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Thromboembolic Event ◽  
Venous Thromboembolic Event ◽  
Low Molecular Weight ◽  
Trauma Patients ◽  
Thromboembolic Complications ◽  
Spine Trauma ◽  
Cord Injury ◽  
Venous Thromboembolic

Abstract INTRODUCTION Up to 80% of spine trauma patients who do not receive thromboprophylaxis have a venous thromboembolic event (VTE) and pulmonary embolism (PE) is a major cause of death, yet national consensus on prophylactic regimens has not been reached. We compared the efficacy of low molecular weight heparin (LMWH) versus unfractionated heparin (UH) in decreasing poor outcomes in spine trauma patients. METHODS Isolated spine trauma cases in the American College of Surgeons Trauma Quality Improvement Program (TQIP) were queried using the Abbreviated Injury Scale (AIS). Patients who received LMWH were compared to UH on adjusted rates of in-hospital mortality, thromboembolic complications (DVT and PE), and total in-hospital complications. RESULTS UH patients had higher rates of spinal cord injury (32.26% vs 25.32%; P < .0001), altered mental status (6.26% vs 5.18%; P = .0005), hypotension on arrival (4.70% vs 4.11%; P = .03) and spinal fusions (29.52% vs 22.94%; P < .0001). LMWH patients had lower rates of mortality (OR: 0.74; 95% CI: 0.62-0.88; P = .0008), thromboembolic complications (OR: 0.75; 95% CI: 0.64-0.88; P = .0003), and total complications (OR: 0.89; 95% CI: 0.83-0.94; P = .0001). While nonfused patients had lower odds of death (OR: 0.35; 95% CI: 0.29-0.43; P < .0001), thromboembolic (OR: 0.71; 95% CI: 0.58-0.87; P = .001), and any complications (OR: 0.84; 95% CI: 0.78-0.91; P < .0001) when given LMWH, fused on LMWH had no improvement in these outcomes. CONCLUSION Spinal trauma patients who received LMWH were less likely to die, have thromboembolic complications and any complication compared to those who received UH. Further research, including randomized clinical trials, is necessary to investigate this potential benefit.

scholarly journals PATHOGENETIC APPROACHES AND WAYS OF PREVENTION OF THROMBOEMBOLIC COMPLICATIONS IN TRAUMA PATIENTS

2018 ◽  
Author(s):  
L. Yu. Ivashchuk
Keyword(s):  
Color Doppler ◽  
Lower Limbs ◽  
Major Surgery ◽  
Trauma Patients ◽  
Thromboembolic Complications ◽  
Surgical Prophylaxis ◽  
Time Duration ◽  
Prothrombin Index ◽  
Positive Treatment ◽  
Significant Disease

Background. The study of thromboembolic complications prevention in trauma patients, who underwent surgery, is presented in the research.Objective. Patients were examined in the Department of Traumatology of Ternopil Municipal Hospital. The first group, 263 people, (18.6 %) consisted of patients with polytrauma and unfavorable prognosis and significant disease severity. The second group comprised patients with combined trauma, 462 people (32.8 %) – a doubtful prognosis for life. The third group, 685 people (48.6 %) involved patients with isolated trauma and positive treatment outcome.Methods. All patients, besides general clinical examination, underwent evaluation of the number of platelets, clotting time, duration of bleeding and study of coagulation (prothrombin index, prothrombin activity thrombotest, total fibrinogen, fibrinogen A, activated recalcification time). The venous system of lower limbs was examined using distal ascending phlebography, color Doppler and duplex ultrasonography SIMENS ACUSSON X 300.Results. A comprehensive prophylaxis of thromboembolic complications was carried out using low-molecular weight heparin as well as essential complex kinetic treatment. Bemiparin in an appropriate dose was administered once a day for 10-14 days of postoperative stay in the hospital. For the patients with moderate risk and high surgery risk (major surgery, over 40 years old in age, obesity, and serious comorbidities) Bemiparin was administered at a dose of 5000-7500 IU per day during patients’ stay in the hospital. In individuals with sub-acute and chronic thrombophlebitis of subcutaneous veins the surgical prophylaxis of thromboembolic complications was performed.Conclusions. The combination of physical, drug and surgical prophylaxis prevented the thromboembolic complications in trauma patients.

Pulmonary emboli due to venous aneurysm of extremities

VASA ◽  
2011 ◽  
Vol 40 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Gabrielli ◽  
Rosati ◽  
Vitale ◽  
Millarelli ◽  
Siani ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Surgical Resection ◽  
Potential Risk ◽  
Acute Pulmonary Embolism ◽  
Prophylactic Surgery ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Thromboembolic Events ◽  
Thromboembolic Complications ◽  
Risk Patients

Venous aneurysms are uncommon but they can have devastating consequences, including pulmonary embolism, other thromboembolic events and death. We report six cases of venous aneurysm of the extremities, in which the first sign of presence was acute pulmonary embolism. Surgical resection is recommended whenever possible. Our experience suggests that prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for extremity deep and superficial venous aneurysms for their potential risk of developing thromboembolic complications despite adequate anticoagulation. Other venous aneurysms should be excised only if they are symptomatic or enlarging.

Venous thromboembolism in a general hospital. An update with low molecular weight heparin prophylaxis

VASA ◽  
2007 ◽  
Vol 36 (1) ◽  
pp. 17-22
Author(s):  
Schulz ◽  
Kesselring ◽  
Seeberger ◽  
Andresen
Keyword(s):  
Molecular Weight ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Low Molecular Weight ◽  
Trauma Patients ◽  
Vte Prophylaxis ◽  
Vein Thrombosis ◽  
Patients At Risk ◽  
Hospital Stays ◽  
Event Rates

Background: Patients admitted to hospital for surgery or acute medical illnesses have a high risk for venous thromboembolism (VTE). Today’s widespread use of low molecular weight heparins (LMWH) for VTE prophylaxis is supposed to have reduced VTE rates substantially. However, data concerning the overall effectiveness of LMWH prophylaxis is sparse. Patients and methods: We prospectively studied all patients with symptomatic and objectively confirmed VTE seen in our hospital over a three year period. Event rates in different wards were analysed and compared. VTE prophylaxis with Enoxaparin was given to all patients at risk during their hospital stay. Results: A total of 50 464 inpatients were treated during the study period. 461 examinations were carried out for symptoms suggestive of VTE and yielded 89 positive results in 85 patients. Seventy eight patients were found to have deep vein thrombosis, 7 had pulmonary embolism, and 4 had both deep venous thrombosis and pulmonary embolism. The overall in hospital VTE event rate was 0.17%. The rate decreased during the study period from 0.22 in year one to 0,16 in year two and 0.13 % in year three. It ranged highest in neurologic and trauma patients (0.32%) and lowest (0.08%) in gynecology-obstetrics. Conclusions: With a simple and strictly applied regimen of prophylaxis with LMWH the overall rate of symptomatic VTE was very low in our hospitalized patients. Beside LMWH prophylaxis, shortening hospital stays and substantial improvements in surgical and anasthesia techniques achieved during the last decades probably play an essential role in decreasing VTE rates.

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