J Korean Fract Soc.  2012 Oct;25(4):250-256. 10.12671/jkfs.2012.25.4.250.

The Incidence of Venous Thromboembolism in Trauma Patients with Pelvic or Acetabular Fracture

Affiliations
  • 1Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. H00106@paik.ac.kr

Abstract

PURPOSE
To evaluate the incidence of venous thromboembolism (VTE) in trauma patients with pelvic or acetabular fracture and determine high risk factors.
MATERIALS AND METHODS
Twenty-three patients who had a pelvic or acetabular fracture were enrolled between March 2011 and February 2012. All patients had mechanical and chemical prophylaxis and underwent deep vein thrombosis (DVT) computed tomography around 2 weeks after injury for evaluation of VTE. The relationships between VTE and each of sex, age, body mass index, injury severity score, intensive care unit stay, transfusion, operation time, coagulopathy, and associated injury were analyzed.
RESULTS
A total of 8 patients developed VTE (34.8%), of which 5 had DVT, 2 had pulmonary embolism (PE), and one had both DVT and PE. The group with a VTE risk score of 14 or more had a significantly higher incidence of VTE.
CONCLUSION
Careful attention is needed in management of patients with pelvic or acetabular fracture.

Keyword

Pelvis; Pelvis fracture; Acetabular fracture; Venous thromboembolism; Deep vein thrombosis; Pulmonary embolism

MeSH Terms

Body Mass Index
Humans
Incidence
Injury Severity Score
Intensive Care Units
Pelvis
Pulmonary Embolism
Venous Thromboembolism
Venous Thrombosis

Figure

  • Fig. 1 A 21-year-old female with injury severity score 29. (A) Three-dimensional computed tomography (CT) image of the pelvis showing pelvic ring injury (jumper's fracture) and right acetabular fracture (both column). (B) Sagittal reconstruction image of the lumbar-spine showing an L1 bursting fracture with neurologic deficit. (C) Postoperative X-ray of lumbar-spine. (D) Chest CT image showing a filling defect in the posterobasal segmental pulmonary artery right with vital sign 142/88-37.7-120-22 at postoperative 6 days. (E) Inferior vena cava filter insertion. (F) Postoperative X-ray after definitive surgery.

  • Fig. 2 Comparison of the rate of venous thromboembolism between subgroup with risk scores of 13 or less and 14 or more. VTE: Venous thromboembolism.


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