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Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention

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dc.contributor.authorRatnasekera, Asanthien
dc.contributor.authorPulido, Odessaen
dc.contributor.authorDurgin, Sandraen
dc.contributor.authorNichols, Sharonen
dc.contributor.authorLozano, Alicia J.en
dc.contributor.authorSienko, Danielleen
dc.contributor.authorHanlon, Alexandra L.en
dc.contributor.authorMartin, Niels D.en
dc.date.accessioned2021-10-05T16:57:07Zen
dc.date.available2021-10-05T16:57:07Zen
dc.date.issued2020-01en
dc.date.updated2021-10-05T16:57:05Zen
dc.description.abstractBackground Trauma patients with penetrating vascular injuries have a higher rate of venous thromboembolism (VTE). The objective of this study was to determine the risk of VTE formation in penetrating femoral and popliteal vascular injuries and the effects of endovascular management of these injuries. Methods A retrospective study of Pennsylvania Trauma Outcome Study registry was conducted during a 5-year period (2013-2017). All adult patients with a penetrating mechanism with femoral/popliteal vascular injuries were studied. Primary outcome was incidence of VTE in patients with isolated arterial injuries versus combined arterial/venous injuries. Secondary endpoints were intensive care unit (ICU) length of stay (LOS), hospital LOS and mortality. Statistical comparisons were accomplished using Fisher's exact tests, and parametric two-sample t-tests or non-parametric Wilcoxon rank-sum tests for categorical and continuous variables, respectively. Results: Of the 865 patients with penetrating extremity vascular injuries, 207 had femoral or popliteal artery injuries. Patients with isolated arterial injuries (n=131) had a significantly lower deep venous thrombosis (DVT) rate compared with those with concurrent venous injuries (n=76) (3.1% vs. 13.2%, p=0.008). There were 14 patients in the study who developed DVTs. Among the four patients with isolated femoral or popliteal arterial injuries who had developed DVTs, three had an open repair. Among patients with isolated arterial injuries, those with DVT spend significantly more time on the ventilator (median=2 vs. 0, p=0.0020) compared with patients without DVT. Patients with DVT also had longer stay in the hospital (median=17.5 vs. 8, p=0.0664) and in the ICU (median=3 vs. 1, p=0.0585). Conclusions: Risk of DVT exists in patients with penetrating isolated femoral and popliteal artery trauma. Open repair was associated with significantly higher DVT rates in isolated arterial injuries. Level of evidence: Level IV therapeutic care/management.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1136/tsaco-2020-000468en
dc.identifier.eissn2397-5776en
dc.identifier.issn2397-5776en
dc.identifier.issue1en
dc.identifier.orcidHanlon, Alexandra L. [0000-0002-9612-2197]en
dc.identifier.otherPMC7295438en
dc.identifier.othertsaco-2020-000468 (PII)en
dc.identifier.pmid32566757en
dc.identifier.urihttp://hdl.handle.net/10919/105169en
dc.identifier.volume5en
dc.language.isoenen
dc.publisherBMJen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/32566757en
dc.rightsCreative Commons Attribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectfemoral arteryen
dc.subjectpenetrating traumaen
dc.subjectpopliteal arteryen
dc.subjectvenous thromboembolismen
dc.titleVenous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased preventionen
dc.title.serialTrauma Surgery & Acute Care Openen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherresearch-articleen
dc.type.otherJournal Articleen
dcterms.dateAccepted2020-05-13en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/Scienceen
pubs.organisational-group/Virginia Tech/Science/Statisticsen
pubs.organisational-group/Virginia Tech/Faculty of Health Sciencesen

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