• Kyle J Kalkwarf, Yijiong Yang, Stephen Mora, Dwayne A Wolf, Ronald D Robertson, John B Holcomb, and Stacy A Drake.
• The University of Arkansas for Medical Sciences, Department of General Surgery, Division of Trauma and Acute Care Surgery, 4301W. Markham St. Slot 520-1, Little Rock, Arkansas 72205, United States. Electronic address: KJKalkwarf@uams.edu.
• Injury. 2023 Nov 1; 54 (11): 111016111016.

IntroductionPulmonary embolism (PE) is a recognized cause of death in hospitalized trauma patients, yet less is known about PE after discharge.Patients & MethodsAll post-discharge, autopsy-demonstrated, fatal PE resulting from trauma within a large US county over six years were analyzed. Counts, percentages, mean values, SD, and IQR were calculated for all variables.Results1848 trauma deaths were reviewed, of which 85% had an autopsy. Eighty-five patients died from PE after discharge from their initial injury. 53% were initially treated at non-trauma centers, and 9% did not seek medical assistance. 75% were injured by falling, and most injuries occurred in the lower extremities. 86% had an ISS <16, but 87% needed assistance or were bed-bound after injury, despite 75% having no mobility limitations before the injury. 53% died within one month of injury, and 91% within the first year. Before death, only 11% were prescribed chemical thromboprophylaxis or an antiplatelet agent, and only 8% were diagnosed with venous thromboembolism before death.ConclusionsFatal PE after discharge typically occurred following activity-limiting lower extremity injuries with an ISS<16.Copyright © 2023 Elsevier Ltd. All rights reserved.

19 keywords...

hide…