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European Journal of Trauma and Emergency Surgery

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01-12-2018 | Review Article

No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review

Authors: Hiba Abdel Aziz, Barbara M. Hileman, Elisha A. Chance

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2018

Abstract

Purpose

To assess the effect of surveillance on deep vein thrombosis (DVT) and pulmonary embolism (PE) rates, the efficacy of chemoprophylaxis and mechanical prophylaxis, and the relationship between DVT and PE.

Methods

A 23 year, systematic literature review was performed in PubMed. Twenty publications with > 13,000 patients were reviewed. Analyzed traits included: DVT surveillance utilization, the total number of patients included in each study, the number of patients developing DVT and/or PE, chemoprophylaxis and mechanical prophylaxis utilization. When event proportions from individual studies were combined, a weighted mean proportion was computed based on the size of each individual cohort. Combined event proportions were compared with other combined event proportions, according to differences in intervention. Inter-group event proportions were compared using Chi-Square or Fisher’s exact test, as appropriate.

Results

DVT rates increase with surveillance (10.7% vs. 2.5%, p < 0.001). PE rates were similar regardless of surveillance (p = 1.0). Chemoprophylaxis lowered both DVT rates (8.2% vs. 10.7%; p < 0.0001) and PE rates (1.2% vs. 1.9%; p = 0.0050). Mechanical prophylaxis did not decrease DVT rates (10.2% vs. 11.5%; p = 0.2980) or PE rates (1.7% vs. 1.6%; p = 1.0). In patients with neither chemoprophylaxis nor mechanical prophylaxis, DVT rate was 11.5%, PE was 1.6%. When chemoprophylaxis and/or mechanical prophylaxis were given, DVT rate was 8.6% (p < 0.0189) and PE was 1.3% (p = 0.4462). PE proportions were not decreased with mechanical prophylaxis or surveillance. DVT and PE rates were not associated (p = 0.7574).

Conclusions

The results suggest that PE is not associated with lower extremity DVT in adult trauma patients.

Available only for authorised users

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Title: No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review
Authors: Hiba Abdel Aziz
Barbara M. Hileman
Elisha A. Chance
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2018
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-1043-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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