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首页> 外文期刊>Archives of orthopaedic and trauma surgery. >Is upper extremity trauma an independent risk factor for lower extremity venous thromboembolism? An 11-year experience at a Level I trauma center.
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Is upper extremity trauma an independent risk factor for lower extremity venous thromboembolism? An 11-year experience at a Level I trauma center.

机译：上肢创伤是否是下肢静脉血栓栓塞的独立危险因素？在一级创伤中心拥有11年的经验。

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INTRODUCTION: Venous thromboembolism (VTE) is an important problem in orthopedic trauma patients. An association between VTE and upper extremity injury has not been reported. The purpose of this investigation was to determine whether upper extremity trauma is an independent risk factor for lower extremity VTE. This study also attempted to identify associations between VTEs and demographic and injury variables in patients that sustained upper extremity trauma. METHODS: Eleven years of data from the trauma registry at our Level I trauma center was retrospectively reviewed in an injury-matched cohort study. From an initial pool of 646 patients who sustained upper extremity trauma, 32 subjects (4.95%) were identified as having major upper extremity injuries as well as thromboembolic complications. Thirty-two injury-matched controls were randomly selected from the 646 patients with major upper extremity injuries. Regression analysis was performed to determine variables that were significantly associated with lower extremity thromboembolic complications. RESULTS: Overall incidence of VTE in patients sustaining upper extremity injury was 4.95% (deep vein thrombus 4.64%, pulmonary embolism 0.31%) and was similar to the 4.95% VTE rate in patients without upper extremity injury. Major head injury (p = 0.022) occurred at increased frequency in the VTE group. Patients with increased length of hospital stay (p < 0.001) and length of time on a ventilator (p = 0.002) were at significantly higher risk for thromboembolic complications. No patient with isolated upper extremity trauma had complications from VTE. CONCLUSION: Lower extremity VTE occurs at similar rates in patients sustaining upper extremity injury compared to those patients that do not. Major upper extremity orthopedic trauma is not an independent risk factor for lower extremity VTE, and current clinical management guidelines for VTE prophylaxis are adequate for patients sustaining major upper extremity trauma.
机译：简介：静脉血栓栓塞症（VTE）是骨科创伤患者的重要问题。 VTE和上肢损伤之间没有关联的报道。这项研究的目的是确定上肢创伤是否是下肢VTE的独立危险因素。这项研究还试图确定持续上肢创伤患者的VTE与人口统计学和损伤变量之间的关联。方法：我们在一项伤害匹配队列研究中回顾性地回顾了我一级创伤中心创伤登记处提供的11年数据。在最初的646例上肢外伤患者中，有32例（4.95％）被确定为患有上肢严重损伤和血栓栓塞并发症。从646例上肢严重损伤患者中随机选择了32个损伤匹配对照。进行回归分析以确定与下肢血栓栓塞并发症显着相关的变量。结果：上肢损伤患者的VTE总体发生率为4.95％（深静脉血栓为4.64％，肺栓塞为0.31％），与无上肢损伤的患者的VTE率为4.95％相似。在VTE组中，重度颅脑损伤（p = 0.022）发生频率增加。住院时间延长（p <0.001）和呼吸机时间延长（p = 0.002）的患者发生血栓栓塞并发症的风险明显更高。没有上肢外伤的患者没有VTE引起的并发症。结论：上肢VTE受累的上肢发生率与未发生下肢VTE的发生率相似。上肢大骨科创伤不是下肢VTE的独立危险因素，目前预防VTE的临床管理指南对于承受上肢大创伤的患者是足够的。

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