Abstract
Introduction: Pulmonary embolism (PE) is a recognized cause of death in hospitalized trauma patients, yet less is known about PE after discharge. Patients & Methods: All post-discharge, autopsy-demonstrated, fatal PE resulting from trauma within a large US county over six years were analyzed. Counts, percentages, mean values, SD, and IQR were calculated for all variables. Results: 1848 trauma deaths were reviewed, of which 85% had an autopsy. Eighty-five patients died from PE after discharge from their initial injury. 53% were initially treated at non-trauma centers, and 9% did not seek medical assistance. 75% were injured by falling, and most injuries occurred in the lower extremities. 86% had an ISS <16, but 87% needed assistance or were bed-bound after injury, despite 75% having no mobility limitations before the injury. 53% died within one month of injury, and 91% within the first year. Before death, only 11% were prescribed chemical thromboprophylaxis or an antiplatelet agent, and only 8% were diagnosed with venous thromboembolism before death. Conclusions: Fatal PE after discharge typically occurred following activity-limiting lower extremity injuries with an ISS<16.
Original language | English (US) |
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Article number | 111016 |
Journal | Injury |
Volume | 54 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2023 |
Keywords
- Anticoagulation
- Antiplatelet
- Autopsy
- DVT
- Fracture
- Pulmonary emboli
- Thromboembolism
- Trauma
- VTE prophylaxis
ASJC Scopus subject areas
- Emergency Medicine
- Orthopedics and Sports Medicine