The effect of screening for deep vein thrombosis on the prevalence of pulmonary embolism in patients with fractures of the pelvis or acetabulum: a review of 973 patients.
OBJECTIVE
In patients with pelvic or acetabular fractures, to compare the prevalence of pulmonary embolism in a time period without screening for deep vein thrombosis to that seen when a screening protocol was in place.


METHODS
Retrospective.


METHODS
County hospital.


METHODS
All patients with closed fractures of the pelvis or acetabulum treated during the study periods.


METHODS
Prophylaxis for deep vein thrombosis was the same for both groups. From November 1, 1997 though November 31, 1999, a screening protocol for deep vein thrombosis was employed using ultrasound and magnetic resonance venography. From January 1, 2000 through December 1, 2001, no screening was used.


METHODS
Pulmonary emboli were recorded.


RESULTS
The 1997 to 1999 time period included 486 patients with fractures of the pelvis or acetabulum; the 2000 to 2001 time period included 487. In the period when a screening protocol was in place, 10 patients (2%) were diagnosed with pulmonary embolism by pulmonary arteriogram, autopsy, or ventilation perfusion scan. All but 2 who were diagnosed with pulmonary embolism had undergone screening for deep vein thrombosis, and none of the screening tests were positive. In the 2000 to 2001 time period, when no screening for deep vein thrombosis was done, 7 patients (1.4%) were diagnosed with pulmonary embolism, by pulmonary arteriogram, autopsy, spiral computed tomography scan, or high clinical suspicion. There was no significant difference between the prevalence of pulmonary embolism seen in 1997 to 1999 and that seen in 2000 to 2001 (P = 0.48).


CONCLUSIONS
Discontinuation of screening for the diagnosis of deep vein thrombosis did not change the rate of pulmonary embolism.
Borer
Drake S
DS
Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8883, USA.
Starr
Adam J
AJ
Reinert
Charles M
CM
Rao
Ashutosh V
AV
Weatherall
Paul
P
Thompson
Daniel
D
Champine
Julie
J
Jones
Alan L
AL
D000077:Acetabulum / Q000293:injuries* / Q000601:surgery; D002985:Clinical Protocols; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000175:diagnosis*