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Author (year) | Trauma population | PE incidence n/N (%) | Postinjury time course of PE | Comments |
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Owings [18] (1997) | Patients admitted to single level 1 university trauma center from 1990 to 1995 | 63/18,255 (0.3%) | PEs occurred from days 1 to 30 following traumatic injury; one quarter of PEs occurred within first 4 days | 58 (92%) of the PE patients had at least one of the accepted risk factors for VTE |
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Sing [16] (2006) | Retrospective chart review of trauma patients with PE 2001 to 2004 at four level 1 trauma centers | 146/25,658 (0.6%) | Mean time to PE 7.9 ± 8.1 days, range 1 to 43 days; 24 PE occurred ≥15 days after injury, 16 (11%) ≥21 days (including 1 fatal) | IVC filters not deployed in these patients; the authors argued that the duration of filter implantation should be individualized |
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Brakenridge [19] (2011) | Patients admitted to single level 1 urban trauma center from 2003 to 2007 | 108/17,736 (0.6%) | 25% within first 72 hours, 50% within first 4 days, 95% within 20 days; 6 cases diagnosed between 24 and 74 days | Long bone fractures independently predicted early PE (≤4 days, OR 2.8); severe head injuries associated with late PE (>4 days, OR 11.1) |
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Batty [20] (2012) | Retrospective chart review of data collected prospectively July 2001 to July 2008 in Australian hospital trauma registry | 45/6344 (0.71%) | Mean time to PE 12 days postinjury (range 0 to 48 days) | Independent predictors of PE: absence of IVC filter, number of injuries to lower limb, central venous catheterization |
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Coleman [17] (2015) | Retrospective chart review of trauma patients with PE 2007 to 2013 at three level 1 trauma centers | 133/54,964 (0.24%) | Median time from admission to diagnosis of PE 4 hospital days (IQR 1–8), when 79 of PE occurred; 42.9% of PE diagnosed within first 3 days (early PE), 57.1% with late PE | Long bone fracture with extremity AIS score ≥3 significantly predicted early PE (p <0.05); severe brain injury, spinal cord injury, and blood transfusion ≤24 hours predicted late PE |
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Van Gent [21] (2017) | Retrospective chart review of all adult patients who had ≥1 duplex ultrasound July 2006 through December 2011 at San Diego level 1 trauma center | 2370 qualifying patients — 265 (11.2%) developed VTE: 235 DVT only, 19 PE only, 11 both DVT and PE | 58 (25%) of all DVT occurred in the first day versus 1 (5%) of all PE; within 2 days of admission, 38% of DVT had occurred versus 26% of PE | For the 19 patients with PE only, all but one of the events were diagnosed within 43 days after admission; risk factors for PE and DVT after injury were different |
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