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Prophylactic Greenfield filter placement in selected high-risk trauma patients
S Khansarinia1, J W Dennis, H C Veldenz
1Department of Surgery, University of Florida Health Science Center/Jacksonville 32209, USA.
Journal of Vascular Surgery
|September 1, 1995
Summary
Prophylactic Greenfield filter (PGF) placement effectively prevented pulmonary embolus (PE) in high-risk trauma patients. This intervention significantly reduced PE incidence and fatalities, suggesting a role in improving outcomes for trauma survivors.
Area of Science:
- Trauma surgery
- Vascular surgery
- Critical care medicine
Background:
- Pulmonary embolism (PE) is a significant cause of mortality in severely injured patients.
- Routine deep venous thrombosis prophylaxis is insufficient for certain high-risk trauma populations.
- Identifying effective preventative strategies for PE in trauma is crucial.
Purpose of the Study:
- To assess the safety and efficacy of prophylactic Greenfield filter (PGF) placement.
- To evaluate PGF in multiple trauma patients with high-risk PE injuries.
- To compare outcomes with historical controls.
Main Methods:
- Prospective placement of PGF in 108 high-risk trauma patients (ISS > 9) with specific criteria.
- Inclusion criteria: severe head injury, spinal cord injury, major venous injury, or pelvic/lower extremity fractures.
- Comparison with 216 historically matched control patients.
Main Results:
- No PE occurred in the PGF group (0/108).
- 13 PEs occurred in the control group, with 9 fatal (p < 0.009).
- PE-related deaths were significantly lower in the PGF group (p < 0.03).
Conclusions:
- Prophylactic Greenfield filter insertion is effective in preventing fatal and nonfatal PE in selected high-risk trauma patients.
- PGF placement may contribute to reduced overall mortality rates.
- Consideration of PGF for trauma patients at high risk for PE is recommended.