Pulmonary embolism following complex trauma: UK MTC observational study

Area of Science:

• Trauma Care
• Critical Care Medicine
• Vascular Surgery

Background:

• Pulmonary embolism (PE) is a significant risk for critically ill trauma patients.
• Understanding the incidence and timing of PE in major trauma centres (MTCs) is crucial for patient management.
• Immediate PE, diagnosed on initial scans, requires specific attention.

Purpose of the Study:

• To determine the incidence of pulmonary embolism (PE) in critically ill patients within a UK major trauma centre.
• To categorize the timing of PE presentation (immediate, early, late).
• To investigate the association between tranexamic acid (TXA) administration and PE development.

Main Methods:

• Retrospective descriptive study of trauma patients admitted to level 2 or 3 care in an East of England MTC.
• Data collected from November 2014 to May 2017, including demographics, injury details, care processes, and PE prophylaxis.
• PE presentation classified based on diagnosis timing relative to admission.

Main Results:

• Of 1039 eligible patients, 4.6% (48) were diagnosed with PE.
• Immediate PEs accounted for 1.3% (14) of cases.
• PE incidence was 6.3% in patients receiving TXA versus 3.8% in those not receiving TXA (p=0.08).

Conclusions:

• This study reports the largest incidence of PE in UK MTC patients, including the most immediate PEs in a civilian complex trauma cohort.
• Immediate PEs are infrequent, and their clinical significance requires further investigation.
• Tranexamic acid use was not significantly linked to an increased risk of PE in this trauma population.