title: Immediate post-traumatic pulmonary embolism is not associated with right ventricular dysfunction.
abstract: BACKGROUND
  Post-traumatic pulmonary embolic events are associated with significant morbidity. Computed tomographic (CT) measurements can be predictive of right ventricular (RV) dysfunction after pulmonary embolus. However, it remains unclear whether these physiologic effects or clinical outcomes differ between early (<48 hours) vs late (≥48 hours) post-traumatic pulmonary embolism (PE).
  
  
  METHODS
  All patients with traumatic injury and CT evidence of PE between 2008 and 2013 were identified. The study population was divided into 2 groups based on the time of diagnosis of the PE. The primary outcome was PE-related mortality.
  
  
  RESULTS
  Fifty patients were identified (14 early PE and 36 late PE). Patients sustaining a late PE had a higher PE-related mortality rate (16.7% vs 0%), larger RV diameters, RV/left ventricular diameter ratios, RV volumes, and RV/left ventricular volume ratios (all P < .05).
  
  
  CONCLUSIONS
  Early post-traumatic PE appears to be associated with fewer RV physiologic changes than late post-traumatic PE and may be representative of primary pulmonary thrombosis. It remains to be seen whether early CT findings of PE should be managed according to previously established guidelines for embolic disease.
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA. Electronic address: rgelbard@hotmail.com.
authors.forename: Rondi B
authors.initials: RB
authors.lastname: Gelbard
authors.affiliation: Division of Surgery, Henry Ford Hospital/Wayne State University, Detroit, MI, USA.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Karamanos
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.
authors.forename: Amin
authors.initials: A
authors.lastname: Farhoomand
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Keeling
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: McDaniel
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.
authors.forename: Amy D
authors.initials: AD
authors.lastname: Wyrzykowski
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Shafii
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.
authors.forename: Ravi R
authors.initials: RR
authors.lastname: Rajani
mesh_terms: D000328:Adult; D000072226:Computed Tomography Angiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D013997:Time Factors; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*; D014947:Wounds and Injuries / Q000150:complications
keywords: Computed tomography pulmonary angiography; Post-traumatic pulmonary embolism; Right ventricular dysfunction