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https://www.readbyqxmd.com/read/29339844/the-risk-of-deep-vein-thrombosis-in-total-joint-patients-compared-to-orthopaedic-trauma-patients-need-for-new-prevention-guidelines
#1
Michelle Shen, Norele J Cutrera, Ashley C Dodd, Christopher Wallace, Frank R Avilucea, Craig Melbourne, Alex A Jahangir, Hassan H Mir, William T Obremskey, Manish K Sethi
Background: The development of Deep Vein Thrombosis (DVT) is a major concern following orthopaedic surgery. No study has yet to compare the rate and risk factors for DVT between total joint and orthopaedic trauma patients. To evaluate if DVT prophylaxis for trauma should differ from total joints, we explored the rate and risk factors for DVT between both cohorts. Methods: Using a CPT code search from 2005 to 2013 in the ACS-NSQIP database, 150,657 orthopaedic total joint patients and 44,594 orthopaedic trauma patients were identified...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29334497/deep-vein-thrombosis-and-venous-thromboembolism-in-trauma
#2
Keith J Ruskin
PURPOSE OF REVIEW: Deep vein thrombosis (DVT) and pulmonary embolus are major causes of hospital-related morbidity and mortality, and are recognized as complications in patients with traumatic injury. Despite the significant morbidity and mortality associated with DVTs, prophylaxis and treatment are still not well understood and remain the subject of research and debate. RECENT FINDINGS: Elements of the patient's history and physical examination, along with thromboelastography, can be used to predict patients who are at greatest risk of DVT and venous thromboembolism (VTE)...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#3
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29201216/role-of-microrna-26a-in-the-diagnosis-of-lower-extremity-deep-vein-thrombosis-in-patients-with-bone-trauma
#4
Zi Li, Jiangdong Ni
The present study aimed to investigate the role and mechanism of action of microRNA (miR)-26a in deep vein thrombosis (DVT). Peripheral blood was collected from 45 patients with DVT and 40 healthy controls. Levels of miR-26a, chemokine C-C motif ligand (CCL)2 mRNA and CCL7 mRNA were detected using reverse transcription-quantitative polymerase chain reaction and the value of miR-26a in the clinical diagnosis of DVT was assessed using receiver operating characteristic curve analysis. The correlation of miR-26a with CCL2 and CCL7 levels was analyzed using Spearman's rank correlation...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29194315/hereditary-thrombophilia-in-trauma-patients-with-venous-thromboembolism-is-routine-screening-necessary
#5
Kathleen A Cannon, Jayraan Badiee, Jason B Brill, Erik J Olson, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), remains a common complication following trauma. The role of hereditary thrombophilia (HT) in post-traumatic VTE is unknown. In the general population with a first-time DVT, Factor V Leiden (FVL) and prothrombin G20210A mutation (PGM) are the most common types of HT with an incidence of 20-25% and 6-18%, respectively. The objective of this study was to identify the incidence of FVL and PGM in post-traumatic VTE to determine whether routine screening for HT in trauma should be performed...
November 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29190255/relation-of-antifactor-xa-peak-levels-and-venous-thromboembolism-after-trauma
#6
Charles A Karcutskie, Arjuna Dharmaraja, Jaimin Patel, Sarah A Eidelson, Arch G Martin, Edward B Lineen, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: No previous studies have established the optimal antifactor Xa (anti-Xa) level to guide thromboprophylaxis (TPX) dosing with enoxaparin in trauma patients. We hypothesize that achieving 0.2-0.4 IU/mL anti-Xa will decrease venous thromboembolism (VTE) rates after trauma. METHODS: This was a retrospective review of 194 intensive care unit patients sustaining blunt or penetrating trauma from January 2015 to March 2017. All received initial enoxaparin (30 mg BID subcutaneous) and mechanical devices for TPX...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29161465/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#7
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, George A Antoniou, James Rh Scurr, Francesco Torella
BACKGROUND: Venous thromboembolism (VTE) is a serious but preventable cause of morbidity and mortality. Neuromuscular electrical stimulation systems (NMES) for the prevention of VTE may be beneficial for patients in whom pharmacological or standard mechanical prophylaxis methods are contraindicated or are regarded as unsafe or impractical. Although findings of experimental studies suggest that NMES reduce venous stasis, the clinical utility and effectiveness of NMES in VTE prevention remain controversial...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29117053/an-outcome-analysis-of-nurse-practitioners-in-acute-care-trauma-services
#8
Anna Holliday, Damayanti Samanta, Julie Budinger, Jessica Hardway, Audis Bethea
The department of trauma at a Level 1 trauma center sought to improve outcomes by enhancing the continuity of care for patients admitted to trauma services. Departmental leadership explored opportunities to improve this aspect of patient care through expansion of existing trauma nurse practitioner (NP) services. The restructured trauma NP service model was implemented in September 2013. A retrospective study was conducted with patients who presented at the trauma center between September 2012 and August 2015...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29081491/deep-vein-thrombosis-complicated-by-spontaneous-iliopsoas-hematoma-in-patient-with-septic-shock
#9
Muhammad Umer Butt, Lili A Buzsaki, Susan S Smyth, Samy-Claude Elayi
BACKGROUND Spontaneous retroperitoneal hemorrhage (SRH) is a rare and difficult-to-diagnose entity. It is not associated with trauma, pathology, or iatrogenic manipulations. Few cases have been reported, with the only precipitating factor recognized being bleeding diatheses such as anticoagulation states, inherited coagulopathies, and hemodialysis. However, none of these have been described in combination with septic shock, which itself is associated with platelet dysfunction, coagulation dysfunction, and vasculopathy...
October 30, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28900890/high-level-of-venous-thromboembolism-in-critically-ill-trauma-patients-despite-early-and-well-driven-thromboprophylaxis-protocol
#10
S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau
BACKGROUND: Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol. METHODS: This was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28891535/doppler-sonographic-evaluation-of-venogenic-extremity-swellings-analysis-of-170-patients-from-kano-nigeria
#11
A Ismail, A M Tabari, K Isyaku
INTRODUCTION: Deep venous thrombosis (DVT) is a serious problem that can potentially lead to many complications including life-threatening pulmonary arterial thrombosis. Screening and confirmation of the diagnosis are critical in the care of this condition. OBJECTIVES: The objective of this study was to evaluate the role of Doppler sonography in diagnosing DVT and to illustrate the pattern in 170 suspected cases from our local environment. MATERIALS AND METHODS: This study was conducted at our department over 18 months...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28865588/the-effect-of-active-toe-movement-atom-on-calf-pump-function-and-deep-vein-thrombosis-in-patients-with-acute-foot-and-ankle-trauma-treated-with-cast-a-prospective-randomized-study
#12
Ben A Hickey, Andrew Cleves, Raza Alikhan, Neil Pugh, Len Nokes, Anthony Perera
BACKGROUND: Patients with foot and ankle trauma treated with cast are advised to perform toe movements to prevent venous thromboembolism (VTE). Our aim was to determine the effect of active toe movement on asymptomatic deep vein thrombosis (DVT) and venous calf pump function. METHODS: Patients aged 18-60 years with acute foot and ankle trauma requiring below knee non weight bearing cast were randomized to intervention (regular active toe movement) or control groups (n=100)...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28863205/bruises-on-the-ears-and-body
#13
Diana M Sarmiento, Thomas F Northrup, Yu Wah
Over the course of a month, this 34-year-old woman had sought care at our facility--and another--on 3 separate occasions for painful bruises (visits #1 and #3) and deep vein thrombosis (visit #2). The bruises first appeared acutely on her arms, prompting her first visit to our ED and leading to a hospital stay. Several weeks later, the patient developed new bruise-like lesions on her earlobes, face, trunk, and lower extremities. In between these 2 visits, the patient was seen in another ED (and admitted) for right upper extremity DVT and was started on enoxaparin, followed by warfarin...
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863078/the-prevalence-of-chronic-deep-venous-thrombosis-in-trauma-implications-for-hospitals-and-patients
#14
Kathleen A Cannon, Jayraan Badiee, James D Wallace, Jason B Brill, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
INTRODUCTION: Deep venous thrombosis (DVT) is considered a preventable complication in trauma patients. Hospitals risk financial penalties for DVT rates above accepted benchmarks. These penalties do not apply to chronic DVT which develop prior to admission. Lower-extremity duplex ultrasound (LEDUS) can detect characteristics of thrombus chronicity, allowing differentiation of chronic from acute DVT. The objective of this study was to determine the prevalence of chronic DVT in hospitalized trauma patients...
August 31, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28808595/a-case-of-superficial-femoral-arteriovenous-fistula-and-severe-venous-stasis-ulceration-managed-with-an-iliac-extender-prosthesis
#15
Nicole Ilonzo, Selena Goss, Chun Yang, Michael Dudkiewicz
Most femoral artery arteriovenous fistulas occur as a result of percutaneous interventions. However, arteriovenous fistulas can occur in the setting of trauma, with resultant consequences such as heart failure, steal syndrome, or venous insufficiency. Indications for endovascular repair in this setting are limited to patients who are at too high risk for anesthesia, have a hostile groin, or would not survive significant bleeding. We report the case of a traumatic femoral arteriovenous fistula, causing severe venous insufficiency and arteriomegaly, in a 58-year-old male, with history of traumatic gunshot wound complicated by popliteal DVT...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28742784/treatment-and-complications-of-patients-with-ipsilateral-acetabular-and-femur-fractures-a-multicenter-retrospective-analysis
#16
Lisa K Cannada, Justin M Hire, Preston J Boyer, Heidi Israel, Hassan Mir, Jason Halvorson, Gregory J Della Rocca, Bryan Ming, Brian Mullis, Chetan Deshpande
OBJECTIVES: The purpose of this study was to review the treatment of patients with ipsilateral acetabular and femur fractures to provide descriptive demographic data, injury pattern classification, treatment, and evaluate the complication profile reflective of current practices. STUDY DESIGN: Multicenter retrospective cohort. SETTING: Eight Level 1 Trauma Centers. PATIENTS/PARTICIPANTS: One hundred one patients met inclusion criteria...
December 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28736179/venous-thromboembolism-in-burn-patients-is-not-prevented-by-chemoprophylaxis
#17
Sheena Sikora, Anthony Papp
BACKGROUND: Venous thromboembolisms (VTE) including deep venous thrombosis and pulmonary embolism are serious complications following burn trauma. There are inconsistencies in the literature regarding thromboembolic prevention strategies and data suggests that complications occur despite chemoprophylaxis. OBJECTIVE: To determine the prevalence of deep venous thromboembolism and pulmonary embolism in burn patients who are actively being treated with VTE prophylaxis and to determine factors that help predict which anti-coagulated patients are at risk for VTE and may benefit from further treatment...
September 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28721003/patient-compliance-with-venous-thromboembolism-prophylaxis-vte
#18
John Ross Blackwell, Parag Raval, John-Patrick Quigley, Amit Patel, Donald McBride
Venous thromboembolic disease (VTE) comprises pulmonary embolism (PE) and deep vein thrombosis (DVT), and causes morbidity and mortality, particularly in trauma and orthopaedic patients. Prevalence of 0.9% and 1.2% respectively are reported, with mortality rates up to 13.8%. Chemical thromboprophylactic agents including low molecular weight heparin (LMWH) are considered cost effective in reducing VTE risk. Evidence for anti-platelets including Aspirin for VTE prophylaxis is less compelling and is not supported as monotherapy...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#19
Jan-Michael Van Gent, Richard Yee Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given that recent data suggesting postinjury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of postinjury DVT and PE are different...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28642012/evaluation-of-a-device-combining-an-inferior-vena-cava-filter-and-a-central-venous-catheter-for-preventing-pulmonary-embolism-among-critically-ill-trauma-patients
#20
Victor F Tapson, Joshua P Hazelton, John Myers, Claudia Robertson, Ramyar Gilani, Julie A Dunn, Marko Bukur, Martin A Croce, Ann Peick, Sonlee West, Lawrence Lottenberg, Jay Doucet, Preston R Miller, Bruce Crookes, Rajesh R Gandhi, Chasen A Croft, Anthony Manasia, Brian A Hoey, Howard Lieberman, Oscar D Guillamondegui, Victor Novack, Gregory Piazza, Samuel Z Goldhaber
PURPOSE: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients. MATERIALS AND METHODS: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first...
June 20, 2017: Journal of Vascular and Interventional Radiology: JVIR
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