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San Francisco Injury Center (SFIC) »  Pulmonary Embolism after Trauma

Pulmonary Embolism After Trauma

Project Director/Lead Investigator: M. Margaret Knudson MD

Investigators at the Injury Center have had a long-standing interest in preventing post-traumatic thromboembolic complications (venous thromboembolic events (VTE); deep venous thrombosis (DVT) and pulmonary embolism (PE). Recently, despite vigorous application of prophylactic measure for VTE prevention, we have noted an increase in the number of PE discovered, likely the result of increased imaging with chest CT scans which are capable of detecting event small peripheral clots. We thus queried the largest trauma data bank available (The American College of Surgeons Committee on Trauma National Trauma Data Base) and together with investigators from the University of Toronto were able to document that the incidence of PE in American Trauma Centers has increased more than 2-fold over the past 10 years, while the attributable death rate decreased from 15% to 11% (Odds ratio of death from PE 4.0 to 2.5). We were also able to discern that chest trauma is significantly associated with the de novo development of PE. This uncoupling to DVT and PE after injury has significant implications for mechanical prevention efforts aimed at DVT as well as for the placement of prophylactic vena cava filters for PE prevention. This paper was presented by Dr. Knudson at the 2011 Annual Meeting of the American Surgical Association in April and the manuscript will be published in the Annals of Surgery.

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