The Effect of Screening for Deep Vein Thrombosis on the Prevalence of Pulmonary Embolism in Patients With Fractures of the Pelvis or Acetabulum

Borer, Drake S.; Starr, Adam J.; Reinert, Charles M.; Rao, Ashutosh V.; Weatherall, Paul T.; Thompson, Daniel; Champine, Julie G.; Jones, Alan L.

doi:10.1097/00005131-200502000-00004

Cited by 57 publications

(32 citation statements)

References 4 publications

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“…Our screening strategy was useful, as the detection rate of VTE in patients with pelvic fractures was high, as other reports, 5,7,10,11 whereas the detection rate of PTE was also high despite the patients being asymptomatic. The high prevalence of PTE in patients with pelvic fractures indicates that screening should be performed as early as possible before PTE becomes symptomatic.…”

Section: Discussionsupporting

confidence: 68%

Venous Thromboembolism in Japanese Patients with Fractures of the Pelvis and/or Lower Extremities Using Physical Prophylaxis Alone

Niikura

Lee

et al. 2012

J Orthop Surg (Hong Kong)

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purpose. To investigate the rate of venous thromboembolism (VTE) in Japanese patients with fractures of the pelvis and/or lower extremities using physical prophylaxis alone. Methods. Records of 66 men and 60 women aged 15 to 95 (mean, 57) years with fractures of the pelvis and/ or lower extremities were retrospectively reviewed. They were screened for VTE based on D-dimer values. Contrast-enhanced computed tomography and/or ultrasonography were performed when the D-dimer value did not decline predictably or exceeded 20 µg/ml even 5 days after injury or surgery. Physical prophylaxis for VTE in terms of graduated compression stockings and intermittent pneumatic compression were applied for all patients. results. Of the 126 patients, 24 were detected to have VTE (10 of 29 with multiple fractures and 14 of 97 with single fractures). Six patients were detected to have asymptomatic pulmonary thromboembolism (PTE), whereas 20 patients were detected to have deep vein thrombosis (bilaterally in 7). The rates of VTE were high in patients with multiple fractures (35%), pelvic fractures (18%), and femoral shaft fractures (50%).Venous thromboembolism in Japanese patients with fractures of the pelvis and/or lower extremities using physical prophylaxis alone Address correspondence and reprint requests to: Dr Takahiro Niikura, Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. E-mail: tniikura@med.kobe-u.ac.jp Journal of Orthopaedic Surgery 2012;20(2):196-200 The rate of PTE was high in patients with pelvic fractures (12%). conclusion. The rate of VTE in the Japanese patients was similar to that in western populations. Our screening method was useful for preventing fatal PTEs. Surgeons should be vigilant for VTE during the first 2 weeks after injury, especially in patients with multiple and pelvic fractures.

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Section: Discussionsupporting

confidence: 68%

Venous Thromboembolism in Japanese Patients with Fractures of the Pelvis and/or Lower Extremities Using Physical Prophylaxis Alone

Niikura

Lee

et al. 2012

J Orthop Surg (Hong Kong)

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“…Among trauma patients, serial screening for DVT failed to identify patients before they developed symptomatic or fatal PE Borer, 2005;Haut, 2007, Moed, 2012). These studies demonstrate that routine screening will detect more asymptomatic DVTs but does not reduce symptomatic thromboembolic events.…”

Section: We Suggest That Sci Patients Not Be Routinely Screened With mentioning

confidence: 99%

“…The costs of DVT screening are substantial, and routine screening of trauma patients has been shown to not be cost-effective (Borer, 2005;Jawa, 2011;Sud, 2011). Among high-risk trauma patients who were given thromboprophylaxis with LMWH, the addition of either serial DUS screening or insertion of an IVC filter was determined to cost more than USD $100,000 per nonfatal PE prevented (Brasel, 1997).…”

Section: We Suggest That Sci Patients Not Be Routinely Screened With mentioning

confidence: 99%

Prevention of Venous Thromboembolism in Individuals with Spinal Cord Injury: Clinical Practice Guidelines for Health Care Providers, 3rd ed.

2016

Topics in Spinal Cord Injury Rehabilitation

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“…Turkiye Klinikleri J Intern Med 2016;1 (1) 68 tected thrombus, pancreas, ovary, liver, and brain malignancies are developing. 3 In some cases, it is emphasized that thrombus is developing after vasculopathies.…”

Section: Multiple Vascular Thrombus Case After Tibial Fractures: Lettmentioning

confidence: 99%

Multiple Vascular Thrombus Case After Tibial Fractures: Letter to the Editor

Ateş¹,

Yılmaz²

2016

Turkiye Klinikleri J Intern Med

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V enous thromboembolism (VTE) is a serious complication that can be seen after hip and lower extremity fractures associated with high morbidity and mortality. While VTE risk of multiple trauma and after hip fracture are quite high, the risk is very low in the distal lower extremity fracture.1,2 VTE can be caused by often the case after fracture in the acute period of immobilization and rarely by vasculopathy may occur due to fracture. In this report, a case one year after the left distal tibia fracture detected the left superficial femoral, popliteal, thrombus in renal and portal vein will be discussed.Thirty-three-years old male patient applied to the clinic complaints with swelling on the left leg and abdominal pain. Swelling in the left leg and decreasing pain was available in story since three weeks. In his story after traffic accident out of motor-vehicle which happened a year ago, fracture in left distal tibia was available. During the application process of the patient vital signs were stable, on physcial examination there were no abnormal findings except swelling on his left ankle. In laboratory tests, routine biochemistry, hemogram, hemostasis parametres were normal, D-dimer detected twice as high. Finding compatible with left superficial femoral in lower ekstremity doppler and chronic deep vein thrombosis in popliteal vein detected. All abdominal ultrasound was normal but in portal and renal vein doppler, thrombus in portal and left renal vein was found, these findings were confirmed by computed tomography angiography. Thrombus in the tests aimed at the etiology thrombophilia, lymphoproliferative disorder, rheumatic disease and malignancy were excluded by available laboratory and clinical situations. Anticoagulant therapy started to the patient and discharged.Unknown origined venous thromboembolisms were mentioned in the literature. It has been stated in unknown origined cases of thromboembolism that either vasculopathy or in following-up malignancies are developing. In a study it has been observed that in following-up some of the cases that de-

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The Effect of Screening for Deep Vein Thrombosis on the Prevalence of Pulmonary Embolism in Patients With Fractures of the Pelvis or Acetabulum

Abstract: Discontinuation of screening for the diagnosis of deep vein thrombosis did not change the rate of pulmonary embolism.

Cited by 57 publications

References 4 publications

Venous Thromboembolism in Japanese Patients with Fractures of the Pelvis and/or Lower Extremities Using Physical Prophylaxis Alone

Venous Thromboembolism in Japanese Patients with Fractures of the Pelvis and/or Lower Extremities Using Physical Prophylaxis Alone

Prevention of Venous Thromboembolism in Individuals with Spinal Cord Injury: Clinical Practice Guidelines for Health Care Providers, 3rd ed.

Multiple Vascular Thrombus Case After Tibial Fractures: Letter to the Editor

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