International Orthopaedics

, Volume 39, Issue 5, pp 947–954 | Cite as

Post-traumatic thrombo-embolic complications in polytrauma patients

  • Philipp LichteEmail author
  • Philipp Kobbe
  • Khalid Almahmoud
  • Roman Pfeifer
  • Hagen Andruszkow
  • Frank Hildebrand
  • Rolf Lefering
  • Hans-Christoph Pape
  • Trauma Register DGU
Original Paper



Thrombo-embolic events after trauma are considered to be life-threatening complications. Our aim was to determine the incidence of arterial and venous thrombo-embolic events (TE) in severely-injured trauma patients, and its associated risk factors by using a large trauma registry.


Patients' data from the TraumaRegister DGU® (TR-DGU) were screened for TE (DVT [symptomatic deep vein thrombosis], PE [symptomatic pulmonary embolism], MI [myocardial infarction], and stroke) through the clinical course of severely injured adult trauma patients from January 2005 to December 2012. Univariate analysis was used to compare the clinical outcomes (endpoints: mortality, ICU and hospital length of stay, ventilator days), and a multivariate regression analysis was used to assess the independent risk factors associated with each TE event.


From a cohort of 40,846 trauma patients, 1122 (2.8 %) patients developed a TE during their post-traumatic clinical course (313, 0.8 % DVT; 425, 1.0 % PE; 160, 0.4 % MI and 231, 0.6 % stroke). ICU length of stay [LOS], total LOS, days on mechanical ventilation, and incidence of multiple organ failure (MOF) and sepsis were significantly increased in patients with TE complications. Injury severity, major pelvic injury, and one or more operations were found to be independent risk factors for the development of DVT. Age ≥ 60 years, male gender, and more than one operation were risk factors for PE development. For MI age was the only significant risk factor. The occurrence of a stroke is increased in patients with an age ≥ 60 years, major head injury (AIS head ≥ 3), and more than one operation. Finally, mortality rates were significantly higher in the TE group when compared to the non-TE cohort (21.8 % vs. 12.7 %; p < 0.001).


TE complications were associated with longer ICU and hospital stay as well as a higher mortality. Overall, age and repeated operations were the most important risk factors for the development of TE events.


Polytrauma Embolic complication Risk factor 


Conflict of interest

All authors declare no conflict of interests.


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Copyright information

© SICOT aisbl 2015

Authors and Affiliations

  • Philipp Lichte
    • 1
    Email author
  • Philipp Kobbe
    • 1
  • Khalid Almahmoud
    • 1
    • 2
  • Roman Pfeifer
    • 1
    • 5
  • Hagen Andruszkow
    • 1
    • 5
  • Frank Hildebrand
    • 1
  • Rolf Lefering
    • 3
  • Hans-Christoph Pape
    • 1
  • Trauma Register DGU
    • 4
  1. 1.Department of Orthopaedic Trauma SurgeryUniversity Hospital AachenAachenGermany
  2. 2.Department of SurgeryUniversity of PittsburghPittsburghUSA
  3. 3.Institute for Research in Operative Medicine (IFOM)University of Witten/HerdeckeCologneGermany
  4. 4.Committee on Emergency Medicine, Intensive Care and Trauma Management of the German Trauma Society (Section NIS)CologneGermany
  5. 5.Harald Tscherne Research Laboratory for Orthopaedic Trauma, Department of Orthopaedic Trauma SurgeryUniversity Hospital RWTH AachenAachenGermany

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