title: Does prehospital prolonged extrication (entrapment) place trauma patients at higher risk for venous thromboembolism?
abstract: BACKGROUND
  The aim of this study was to determine if prolonged immobility and tissue injury from a prehospital entrapment would place patients at higher risk for in-hospital venous thromboembolism (VTE) complications. It was hypothesized that entrapment would increase in-hospital VTE.
  
  
  METHODS
  All consecutive trauma admissions over a 10-year period were retrospectively reviewed. Patients were divided into those who were entrapped according to defined prehospital criteria for entrapment and those who were not entrapped. The complications of deep vein thrombosis and pulmonary embolism were noted.
  
  
  RESULTS
  There were 15,159 patients admitted between 1999 and 2008. Of these, 1,176 met the criteria for prehospital entrapment. Those patients who met the criteria for entrapment had a significant risk for developing both deep vein thrombosis (P < .001, χ(2) test) and pulmonary embolism (P = .005, Fisher's exact test). Multiple logistic regression analysis revealed entrapment to be a significant contributing risk factor to the development of VTE (odds ratio, 1.54; P = .04).
  
  
  CONCLUSIONS
  Patients with prehospital entrapment are at higher risk for VTE. These results mandate aggressive VTE prophylaxis in patients with histories of prehospital entrapment.
authors.affiliation: Division of Trauma, Lancaster General Hospital, PA, USA. frogers2@lghealth.org
authors.forename: Frederick B
authors.initials: FB
authors.lastname: Rogers
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Hammaker
authors.forename: Jo Ann
authors.initials: JA
authors.lastname: Miller
authors.forename: John C
authors.initials: JC
authors.lastname: Lee
authors.forename: Roxanne
authors.initials: R
authors.lastname: Chandler
authors.forename: Mathew M
authors.initials: MM
authors.lastname: Edavettal
authors.forename: Lois U
authors.initials: LU
authors.lastname: Sakorafas
authors.forename: Daniel
authors.initials: D
authors.lastname: Wu
authors.forename: Tracy
authors.initials: T
authors.lastname: Evans
authors.forename: Lanyce A
authors.initials: LA
authors.lastname: Horn
authors.forename: Michael
authors.initials: M
authors.lastname: Horst
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D007103:Immobilization / Q000009:adverse effects*; D016015:Logistic Models; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology; D012042:Registries; D012189:Retrospective Studies; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D014947:Wounds and Injuries / Q000150:complications*