Development of Deep Vein Thrombosis in Severely Injured Multiple Trauma Patients

Kim,  Sangnyun; Lee,  Dongun; Lee,  Bumchul; Park,  Jungbae; Shin,  Sujeong

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Original Article

Journal of Trauma and Injury 2012;25(4):109-114.

Development of Deep Vein Thrombosis in Severely Injured Multiple Trauma Patients

Sangnyun Kim, Dongun Lee, Bumchul Lee, Jungbae Park, Sujeong Shin

Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. dongle7979@gmail.com

중증외상 환자에서 심부정맥혈전 발생에 관한 고찰

김상년∙이동언∙이범철∙박정배∙신수정

경북대학교 의학전문대학원 응급의학교실

Received: 31 July 2012 • Revised: 3 September 2012 • Accepted: 5 October 2012

Abstract

PURPOSE
Deep vein thrombosis and pulmonary thromboembolism are major causes of death after severe multiple trauma. Although various means of prevention have been presented and utilized, still, there are no standard guidelines for anticoagulation of multiple trauma because of some contraindications.
METHODS
A retrospective study of adult major trauma patients whose injury severity scores (ISSs) were over 16 and who had visited one university hospital in Daegu city was performed. We compared some features of patients diagnosed DVT or PTE with those of patients without DVT by computed tomography or ultra sonography. Those features included accompanying various kinds of intracranial hemorrhages, possibility of ambulation, emergent operation, early transfusion, and suspicious symptoms.
RESULTS
The mean age of the 58 subjects included in this study was 50.9+/-17.2 years, the mean ISS was 22.7+/-6.0, and the mean hospital stay was 55.2+/-37.9 days. Ten(17.2%) patients had emergent surgery, and 44(75.9%) experienced delayed surgery. Early transfusion was needed in 34(58.6%) patients. Among the 18 patients diagnosed with DVT, accompanying intracranial hemorrhages were noted in 8(44.4%) patients; one of the 8 also had PTE. Among the same 18 patients, early transfusions were required in 11(61.1%) patients; one of the 11 also had PTE.
CONCLUSION
The risk of DVT is increased in cases of severe multiple trauma, and many difficulties in applying anticoagulants are experienced. Though we need additional studies to decide proper prophylaxis for DVT and PTE, if the patient's general condition permits, a screening test for DVT as soon as possible could be an effective method to reduce the possibility of a bad outcome.

Key Words: Deep vein thrombosis; Major trauma; Prophylaxis

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