[Thromboembolism complication in multiple trauma patients: an underestimated problem? Results of a clinical observational study of 50 patients].
BACKGROUND
The incidence of thromboembolic complications in patients with severe polytrauma in the ICU is not well known. Only a few publications deal with this problem. Systematic investigations in this high-risk patient group are not routinely used.


METHODS
From January 1996 to January 1998, 50 polytrauma patients with a mean ISS > 15 were included in a clinical study to evaluate the incidence of thromboembolism in this patient group. Further inclusion criteria were a minimum stay of 72 h in the ICU and mechanical ventilation for a minimum time of 72 h. All patients were examined with color-coded duplex sonography according to a standardized protocol. The duplex sonography was performed before the patients were first mobilized in the ICU (15 +/- 12.8 days).


RESULTS
If not otherwise indicated all values are given as mean +/- SD. The age of the patients was 38 years (range 17-77 years), the severity of trauma was characterized by an ISS of 40 (range 16-70). Eight of the included patients died during their stay in the ICU after developing a multiple organ failure. According to autopsy data none of them had a deep venous thrombosis or pulmonary embolus. Eight patients (19%) developed deep venous thrombosis, and 4 patients with thrombosis developed pulmonary embolism.


CONCLUSIONS
The incidence of deep venous thrombosis in polytrauma patients seems to be much higher than expected reviewing the results of other publications. The low detection rate of other authors results from using only clinical signs. The routine use of color-coded duplex sonography is effective in detecting unsuspected deep vein thrombosis.
Giannadakis
K
K
Klinik für Unfallchirurgie, der Philipps-Universität Marburg.
Leppek
R
R
Gotzen
L
L
Stiletto
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D012306:Risk; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control