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Deep leg veign thrombosis in multiply injured patients: an underestimated problem? Results of a prospective clinical study with 50 patients

Introduction

Too little is still known about the incidence rate of thromboembolic complications in polytrauma patients after ICU treatment, as only a small amount of data is available on this topic. The majority of the studies published to date that have been performed to assess the incidence rate of thrombosis in multiply injured patients only refer to the clinical symptoms of a venous thrombosis. A systematic screening-examination for the assessment of the incidence rate of thromboembolic complications in the above-mentioned patient collective has not yet gained acceptance as a routine method in clinical practice.

Material and method

Between January 1996 and December 1997, 50 polytrauma patients were included in a prospective clinical study. Including criteria were: an initial ISS-score >16, a stay on the ICU of at least 72 h and a time on the respirator of at least 72 h. All patients were examined for a deep veign thrombosis by using a standardized protocol and by means of a colour-coded duplex (ccd) sonography. In cases in which the clinical or/and sonographic examination yielded results of a suspected veign thrombosis, a phlebography was performed. In cases of a suspected pulmonary embolism a pulmonary angiography was performed. The colour-coded duplex sonography was used before the patients were mobilized or transfered to an other ward (generally after 15 days).

Results

If not indicated otherwise numbers are given as median. The age of the 38 male and 12 female patients was 38.6 years. The severity of trauma was characterized by an ISS-score of 39.5 points. Eight patients died of a multiorgan-failure during their stay on the ICU. The autopsy findings reveal that no patient died of the of a veign thrombosis or a pulmonary embolism. Of the remaining 42 patients, 8 patients (19%) showed deep leg veign thrombosis in the ccd. In three of these patients (7%) also a pulmonary embolism occurred.

Conclusion

Having in mind the results of our study the incidence rate of thromboembolic complications in polytrauma patients seems to be much higher as expected in comparison to the published results of other authors.

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Stiletto, R., Giannadakis, K. & Leppek, R. Deep leg veign thrombosis in multiply injured patients: an underestimated problem? Results of a prospective clinical study with 50 patients. Crit Care 3, P241 (2000). https://doi.org/10.1186/cc614

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Keywords

  • Incidence Rate
  • Female Patient
  • Pulmonary Embolism
  • Emergency Medicine
  • Standardize Protocol