title: Incidence of venous thromboembolism in pelvic and acetabular fractures in the Japanese population.
abstract: BACKGROUND
  There are no detailed reports of the incidence of venous thromboembolism (VTE) in pelvic and acetabular fractures in the Asian population. The purpose of this study was to investigate the incidence of VTE in pelvic and acetabular fractures in the Japanese population.
  
  
  METHODS
  Forty-six Japanese patients with pelvic and acetabular fractures treated at our hospital from February 2004 to April 2011 were analyzed retrospectively. Until April 2009, VTE screening was performed by contrast-enhanced computed tomography (CT) or ultrasonography (US) when the D-dimer value did not decline predictably, still exceeded 20 µg/ml at 5 days after trauma and surgery, or increased >20 µg/ml after a period of decline. After April 2009, contrast-enhanced CT and US were performed routinely irrespective of the D-dimer value. Physical prophylaxis was performed in all patients. The effects of the presence of pelvic and acetabular fractures, fracture types, accompanying injuries, and screening strategies on the incidences of VTE and pulmonary thromboembolism (PTE) were investigated.
  
  
  RESULTS
  Overall, 19 patients (41.3%) were diagnosed with VTE and PTE in ten (21.7%). All were asymptomatic. Compared with trauma patients without pelvic and acetabular fractures treated during the same period, significantly higher incidences of VTE and PTE were observed in patients with pelvic and acetabular fractures. No significant differences were observed in the incidences of VTE and PTE between pelvic and acetabular fractures or between patients with and without accompanying injuries. Compared with the previous screening strategy, the detection rates of VTE and PTE were higher for the newer screening strategy; however, the difference did not reach statistical significance.
  
  
  CONCLUSIONS
  We should be vigilant for the high incidence of VTE, especially PTE, in patients with pelvic and acetabular fractures in the Japanese population.
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. tniikura@med.kobe-u.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Niikura
authors.forename: Sang Yang
authors.initials: SY
authors.lastname: Lee
authors.forename: Keisuke
authors.initials: K
authors.lastname: Oe
authors.forename: Akihiro
authors.initials: A
authors.lastname: Koh
authors.forename: Takaaki
authors.initials: T
authors.lastname: Koga
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Dogaki
authors.forename: Etsuko
authors.initials: E
authors.lastname: Okumachi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kurosaka
mesh_terms: D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006620:Hip Fractures / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult