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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
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Upper Extremity Deep Venous Thrombosis Risk Factors, Associated Morbidity and Mortality in Trauma Patients
Mbaga Walusimbi1, Avafia Y Dossa2, Kiran Faryar2
1Department of Surgery, Wright State University School of Medicine, 128 E. Apple Street, Suite 7000 Weber Center for Health Education, Dayton, OH, 45409, USA. mbaga.walusimbi@wright.edu.
World Journal of Surgery
|January 4, 2022
Summary
Upper extremity deep venous thrombosis (UEDVT) in trauma patients is linked to higher mortality. Key risk factors include fractures, PICC lines, and TBI. Pharmacological prophylaxis significantly reduces UEDVT risk.
Area of Science:
- Trauma Surgery
- Vascular Medicine
- Critical Care Medicine
Background:
- Upper extremity deep venous thrombosis (UEDVT) literature is less extensive than for lower extremities.
- Understanding UEDVT in trauma patients is crucial due to potential mortality and morbidity.
- This study investigates UEDVT risk factors, outcomes, and prophylaxis in trauma admissions.
Purpose of the Study:
- To identify independent risk factors for UEDVT in trauma patients.
- To assess the mortality and morbidity associated with UEDVT in this population.
- To evaluate the impact of pharmacological prophylaxis on UEDVT incidence.
Main Methods:
- Retrospective review of patients admitted to a Level 1 trauma center over three years.
- Inclusion criteria: age ≥18 years, traumatic event, upper extremity ultrasound (UEUS).
- Multiple logistic regression analysis to determine independent risk factors for UEDVT.
Main Results:
- 5.6% of 6,607 trauma patients underwent UEUS; 15% were diagnosed with UEDVT.
- UEDVT was associated with increased mortality (7.1%) and non-fatal pulmonary emboli (PE).
- Independent risk factors identified: upper extremity fractures, peripherally inserted central catheter (PICC) lines, and traumatic brain injury (TBI).
Conclusions:
- UEDVT in trauma patients is associated with significant mortality.
- Upper extremity fractures, PICC lines, and TBI are independent risk factors for UEDVT.
- Pharmacological prophylaxis, particularly with low-molecular-weight heparin (LMWH), demonstrates a protective effect against UEDVT.
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