Predictors of early versus late timing of pulmonary embolus after traumatic injury.
OBJECTIVE
To identify risk factors predictive of pulmonary embolus (PE) timing after a traumatic injury.


METHODS
One hundred eight traumatic injury patients with a confirmed diagnosis of PE were classified as early PE (≤4 days, n = 54) or late PE (>4 days, n = 54). Independent predictors of early versus late PE were identified using multivariate logistic regression.


RESULTS
Half the PEs were diagnosed ≤4 days of injury. Only long bone fractures independently predicted early PE (odds ratio 2.8; 95% confidence interval, 1.1-7.1). Severe head injuries were associated with late PE (odds ratio 11.1; 95% confidence interval, 3.9-31). Established risk factors such as age did not affect timing.


CONCLUSIONS
Half the PEs were diagnosed ≤4 days after injury. The risk of early PE appeared highest in patients with long bone fractures, and the benefits of immediate prophylaxis may outweigh risks. Patients with severe head injuries appear to have later PE events. Prospective interventional trials in these injury populations are needed.
Brakenridge
Scott C
SC
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Toomay
Seth M
SM
Sheng
Jean L
JL
Gentilello
Larry M
LM
Shafi
Shahid
S
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000925:Anticoagulants / Q000008:administration & dosage; D006259:Craniocerebral Trauma / Q000150:complications*; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014193:Trauma Centers; D014505:Urban Population; D014947:Wounds and Injuries / Q000150:complications
D000925:Anticoagulants; D006493:Heparin
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