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Race does matter: venous thromboembolism in trauma patients with isolated severe pelvic fractures

  • Original Article
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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Studies in non-trauma populations have shown that Black patients have a higher risk of venous thromboembolism (VTE) compared to other races. We sought to determine whether this association exists in trauma patients. The incidence of VTE is particularly high following severe pelvic fractures. To limit confounding factors associated with additional injuries, we examined patients with isolated blunt severe pelvic fractures.

Methods

The TQIP database (2013–2017) was queried for all patients who sustained isolated blunt severe pelvic fractures (AIS ≥ 3) and received VTE prophylaxis (VTEp) with either unfractionated heparin or low molecular weight heparin. The study groups were Asian, Black, and White race as defined by TQIP. The primary outcome was differences in the rate of thromboembolic events.

Results

A total of 9491 patients were included in the study. Of these, 232 (2.4%) were Asian, 1238 (13.0%) Black, and 8021 (84.5%) White. There was no significant difference in the distribution of pelvis AIS 3,4,5 between the groups. Black patients had a significantly higher incidence of VTE, DVT and PE compared to Asians and Whites. After adjusting for differences between the groups, Black patients had higher odds of developing pulmonary embolism (OR 1.887, 95% CI 1.101–3.232, p = 0.021) compared to White patients.

Conclusions

In this nationwide study of trauma patients with severe pelvic fractures, Black patients were more likely to develop pulmonary embolism compared to White patients. Further research to identify the determinants of racial disparities in trauma-related VTE is warranted, to target interventions that can improve VTE outcomes for all 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. Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, Los Angeles, CA, USA

    Panagiotis Liasidis, Elizabeth R Benjamin, Dominik Jakob, Li Ding, Meghan Lewis & Demetrios Demetriades

  2. Department of Surgery, Grady Memorial Hospital, Emory University, Glenn Memorial Building, 3rd Flr, 69 Jesse Hills Jr Dr SE, Atlanta, GA, 30303, USA

    Elizabeth R Benjamin

Authors
  1. Panagiotis Liasidis
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  2. Elizabeth R Benjamin
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  4. Li Ding
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Contributions

PKL, ERB, and DD designed the study. PKL and DAJ performed the literature search and data collection. PKL and LD analyzed the data. All authors contributed to the interpretation of the data, writing of the manuscript, and approved the final version of the manuscript. ML, ERB, and DD supervised all aspects of study design, data acquisition, analyses, and manuscript writing.

Corresponding author

Correspondence to Elizabeth R Benjamin.

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All authors declare no potential conflict of interest.

Ethical approval

This study was performed in line with the principles of the 1964 Helsinki Declaration and its later amendments. The Trauma Quality Improvement Program database contains de-identified data and a waiver of informed consent was obtained. The present study was approved by the Institutional Review Board of the University of Southern California.

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Liasidis, P., Benjamin, E.R., Jakob, D. et al. Race does matter: venous thromboembolism in trauma patients with isolated severe pelvic fractures. Eur J Trauma Emerg Surg 49, 241–251 (2023). https://doi.org/10.1007/s00068-022-02044-4

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  • DOI: https://doi.org/10.1007/s00068-022-02044-4

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