Pulmonary embolism in severe traumatic brain injury

Pulmonary emboli (PE) is a significant source of morbidity and mortality in the trauma patients. The use of chemical prophylaxis to prevent deep venous thrombosis and subsequent PE is still controversial given its risk of increased intracranial hemorrhage expansion.

In the present study, we evaluated the incidence of PE in severe traumatic brain injury.

Retrospective review of patients who were admitted to a Neurosurgery unit from 2011 to 2013 with severe TBI who developed PE.

155 patients met the study criteria. The incidence of PE was 2.58%. The cohort was mainly composed of white (71.6%), male (76.77%) with the mean age of 23.03 ± 15.79. There was no statistical difference between the patients who developed PE with prophylaxis and without (p = 0.58). Hospital length of stay was significantly increased by the development of a PE (27.82 ± 21.78 vs. 61.24 ± 25.74 days, p = 0.01).

Our data is limited by a low incidence of PE in this cohort, but does show an increased hospital length of stay. The true incidence of PE is unknown, so large-scale population studies are urgently needed and a high index of suspicion is required for diagnosis.