单位：[1]Department of Trauma Surgery, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China外科学系创伤外科华中科技大学同济医学院附属同济医院[2]Intensive Care Unit, Trauma Center, Suizhou Central Hospital, Hubei University of Medicine, Suizhou 441300, China[3]Department of Trauma Surgery, Trauma Center, Tianmen First People’s Hospital, Hubei University of Science and Technology, Tianmen 417300, China[4]Department of Emergency Medicine, The People’s Hospital of China Three Gorges University, China Three Gorges University, Yichang 443000, China
Venous thrombus embolism (VTE) is common after polytrauma, both of which are considered significant contributors to poor outcomes and mortality. Traumatic brain injury (TBI) is recognized as an independent risk factor for VTE and one of the most common components of polytraumatic injuries. Few studies have assessed the impact of TBI on the development of VTE in polytrauma patients. This study sought to determine whether TBI further increases the risk for VTE in polytrauma patients. A retrospective, multi-center trial was performed from May 2020 to December 2021. The occurrence of venous thrombosis and pulmonary embolism from injury to 28 days after injury was observed. Of 847 enrolled patients, 220 (26%) developed DVT. The incidence of DVT was 31.9% (122/383) in patients with polytrauma with TBI (PT + TBI group), 22.0% (54/246) in patients with polytrauma without TBI (PT group), and 20.2% (44/218) in patients with isolated TBI (TBI group). Despite similar Glasgow Coma Scale scores, the incidence of DVT in the PT + TBI group was significantly higher than in the TBI group (31.9% vs. 20.2%, p < 0.01). Similarly, despite no difference in Injury Severity Scores between the PT + TBI and PT groups, the DVT rate was significantly higher in the PT + TBI group than in the PT group (31.9% vs. 22.0%, p < 0.01). Delayed anticoagulant therapy, delayed mechanical prophylaxis, older age, and higher D-dimer levels were independent predictive risk factors for DVT occurrence in the PT + TBI group. The incidence of PE within the whole population was 6.9% (59/847). Most patients with PE were in the PT + TBI group (64.4%, 38/59), and the PE rate was significantly higher in the PT + TBI group compared to the PT (p < 0.01) or TBI (p < 0.05) group. In conclusion, this study characterizes polytrauma patients at high risk for VTE occurrence and emphasizes that TBI markedly increases the incidence of DVT and PE in polytrauma patients. Delayed anticoagulant therapy and delayed mechanical prophylaxis were identified as the major risk factors for a higher incidence of VTE in polytrauma patients with TBI.
基金：
This study was supported, in part, by grant 81873870 (Z.T.) from the National Natural
Science Foundation of China.
第一作者单位：[1]Department of Trauma Surgery, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
通讯作者：
推荐引用方式(GB/T 7714)：
Chen Deng,Luo Jialiu,Zhang Cong,et al.Venous Thrombus Embolism in Polytrauma: Special Attention to Patients with Traumatic Brain Injury[J].JOURNAL OF CLINICAL MEDICINE.2023,12(5):doi:10.3390/jcm12051716.
APA：
Chen, Deng,Luo, Jialiu,Zhang, Cong,Tang, Liangsheng,Deng, Hai...&Tang, Zhaohui.(2023).Venous Thrombus Embolism in Polytrauma: Special Attention to Patients with Traumatic Brain Injury.JOURNAL OF CLINICAL MEDICINE,12,(5)
MLA：
Chen, Deng,et al."Venous Thrombus Embolism in Polytrauma: Special Attention to Patients with Traumatic Brain Injury".JOURNAL OF CLINICAL MEDICINE 12..5(2023)
医学