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No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To assess the effect of surveillance on deep vein thrombosis (DVT) and pulmonary embolism (PE) rates, the efficacy of chemoprophylaxis and mechanical prophylaxis, and the relationship between DVT and PE.

Methods

A 23 year, systematic literature review was performed in PubMed. Twenty publications with > 13,000 patients were reviewed. Analyzed traits included: DVT surveillance utilization, the total number of patients included in each study, the number of patients developing DVT and/or PE, chemoprophylaxis and mechanical prophylaxis utilization. When event proportions from individual studies were combined, a weighted mean proportion was computed based on the size of each individual cohort. Combined event proportions were compared with other combined event proportions, according to differences in intervention. Inter-group event proportions were compared using Chi-Square or Fisher’s exact test, as appropriate.

Results

DVT rates increase with surveillance (10.7% vs. 2.5%, p < 0.001). PE rates were similar regardless of surveillance (p = 1.0). Chemoprophylaxis lowered both DVT rates (8.2% vs. 10.7%; p < 0.0001) and PE rates (1.2% vs. 1.9%; p = 0.0050). Mechanical prophylaxis did not decrease DVT rates (10.2% vs. 11.5%; p = 0.2980) or PE rates (1.7% vs. 1.6%; p = 1.0). In patients with neither chemoprophylaxis nor mechanical prophylaxis, DVT rate was 11.5%, PE was 1.6%. When chemoprophylaxis and/or mechanical prophylaxis were given, DVT rate was 8.6% (p < 0.0189) and PE was 1.3% (p = 0.4462). PE proportions were not decreased with mechanical prophylaxis or surveillance. DVT and PE rates were not associated (p = 0.7574).

Conclusions

The results suggest that PE is not associated with lower extremity DVT in adult trauma patients.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgical Education, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA

    Hiba Abdel Aziz

  2. Trauma/Neuroscience Research Department, St. Elizabeth Youngstown Hospital, 1044, Belmont Avenue, Youngstown, OH, 44501, USA

    Barbara M. Hileman & Elisha A. Chance

Authors
  1. Hiba Abdel Aziz
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  2. Barbara M. Hileman
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Correspondence to Hiba Abdel Aziz.

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Dr. Hiba Abdel-Aziz, Ms. Barbara M. Hileman and Ms. Elisha A. Chance declare that they have no conflict of interest.

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68_2018_1043_MOESM1_ESM.pdf

Online Resource 1: I2 index analysis of study heterogeneity. Caption: random effects model proportion utilized if I2 p &#x003C; 0.05, and if I2 p ≥ 0.05, the fixed effects model proportion was used. (PDF 239 KB)

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Aziz, H.A., Hileman, B.M. & Chance, E.A. No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review. Eur J Trauma Emerg Surg 44, 843–850 (2018). https://doi.org/10.1007/s00068-018-1043-3

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  • DOI: https://doi.org/10.1007/s00068-018-1043-3

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