title: Post-traumatic thrombo-embolic complications in polytrauma patients.
abstract: BACKGROUND
  Thrombo-embolic events after trauma are considered to be life-threatening complications. Our aim was to determine the incidence of arterial and venous thrombo-embolic events (TE) in severely-injured trauma patients, and its associated risk factors by using a large trauma registry.
  
  
  METHODS
  Patients' data from the TraumaRegister DGU® (TR-DGU) were screened for TE (DVT [symptomatic deep vein thrombosis], PE [symptomatic pulmonary embolism], MI [myocardial infarction], and stroke) through the clinical course of severely injured adult trauma patients from January 2005 to December 2012. Univariate analysis was used to compare the clinical outcomes (endpoints: mortality, ICU and hospital length of stay, ventilator days), and a multivariate regression analysis was used to assess the independent risk factors associated with each TE event.
  
  
  RESULTS
  From a cohort of 40,846 trauma patients, 1122 (2.8%) patients developed a TE during their post-traumatic clinical course (313, 0.8% DVT; 425, 1.0% PE; 160, 0.4% MI and 231, 0.6% stroke). ICU length of stay [LOS], total LOS, days on mechanical ventilation, and incidence of multiple organ failure (MOF) and sepsis were significantly increased in patients with TE complications. Injury severity, major pelvic injury, and one or more operations were found to be independent risk factors for the development of DVT. Age ≥ 60 years, male gender, and more than one operation were risk factors for PE development. For MI age was the only significant risk factor. The occurrence of a stroke is increased in patients with an age ≥ 60 years, major head injury (AIS head ≥ 3), and more than one operation. Finally, mortality rates were significantly higher in the TE group when compared to the non-TE cohort (21.8% vs. 12.7%; p < 0.001).
  
  
  CONCLUSIONS
  TE complications were associated with longer ICU and hospital stay as well as a higher mortality. Overall, age and repeated operations were the most important risk factors for the development of TE events.
authors.affiliation: Department of Orthopaedic Trauma Surgery, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany, plichte@ukaachen.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Lichte
authors.forename: Philipp
authors.initials: P
authors.lastname: Kobbe
authors.forename: Khalid
authors.initials: K
authors.lastname: Almahmoud
authors.forename: Roman
authors.initials: R
authors.lastname: Pfeifer
authors.forename: Hagen
authors.initials: H
authors.lastname: Andruszkow
authors.forename: Frank
authors.initials: F
authors.lastname: Hildebrand
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Pape
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications* / Q000401:mortality; D012042:Registries; D012121:Respiration, Artificial; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology*