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https://www.readbyqxmd.com/read/28110934/-posttraumatic-thromboembolic-complications-incidence-risk-factors-pathophysiology-and-prevention
#1
M Bahloul, K Regaieg, K Chtara, O Turki, N Baccouch, A Chaari, M Bouaziz
Venous thromboembolism (VTE) remains a major challenge in critically ill patients. Subjects admitted in intensive care unit (ICU), in particular trauma patients, are at high-risk for both deep vein thrombosis (DVT) and pulmonary embolism (PE). The rate of symptomatic PE in injured patients has been reported previously ranging from 1 to 6%. The high incidence of posttraumatic venous thromboembolic events is well known. In fact, major trauma is a hypercoagulable state. Several factors placing the individual patient at a higher risk for the development of DVT and PE have been suggested: high ISS score, meningeal hemorrhage and spinal cord injuries have frequently been reported as a significant risk factor for VTEs after trauma...
January 19, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28108019/goal-directed-enoxaparin-dosing-provides-superior-chemoprophylaxis-against-deep-vein-thrombosis
#2
Tammy R Kopelman, Jarvis W Walters, James N Bogert, Usmaan Basharat, Paola G Pieri, Karole M Davis, Asia N Quan, Sydney J Vail, Melissa A Pressman
INTRODUCTION: Optimal enoxaparin dosing for deep venous thrombosis (DVT) prophylaxis remains elusive. Prior research demonstrated that trauma patients at increased risk for DVT based upon Greenfield's risk assessment profile (RAP) have DVT rates of 10.8% despite prophylaxis. The aim of this study was to determine if goal directed prophylactic enoxaparin dosing to achieve anti-Xa levels of 0.3-0.5IU/ml would decrease DVT rates without increased complications. MATERIALS AND METHODS: Retrospective review of trauma patients having received prophylactic enoxaparin and appropriately timed anti-Xa levels was performed...
November 3, 2016: Injury
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#3
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28053388/prevalence-of-deep-vein-thrombosis-in-patients-with-lower-limb-trauma
#4
Chirag S Kapoor, Ashit K Mehta, Krunal Patel, Paresh P Golwala
INTRODUCTION: Venous thrombo-embolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal condition. According to Western literature, DVT of lower limb veins is one of the most common complications following surgeries for lower limb. Few studies have been published from India on the subject and little is known about the true prevalence of the DVT and hence there are no clear guidelines regarding the prophylaxis for DVT for Indian patients...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#5
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27779597/abnormalities-in-fibrinolysis-at-the-time-of-admission-are-associated-with-deep-vein-thrombosis-mortality-and-disability-in-a-pediatric-trauma-population
#6
Christine M Leeper, Matthew D Neal, Christine McKenna, Jason L Sperry, Barbara A Gaines
BACKGROUND: Abnormalities in fibrinolysis are common and associated with increased mortality in injured adults. While hyperfibrinolysis (HF) and fibrinolysis shutdown (SD) are potential prognostic indicators and treatment targets in adults, these derangements are not well described in a pediatric trauma cohort. METHODS: This was a prospective analysis of highest level trauma activations in subjects aged 0 to 18 years presenting to our academic center between June 1, 2015, and July 31, 2016, with admission rapid thrombelastograph...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27692532/retrievable-inferior-vena-cava-filters-in-trauma-patients-prevalence-and-management-of-thrombus-within-the-filter
#7
Y Pan, J Zhao, J Mei, M Shao, J Zhang, H Wu
OBJECTIVE: The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. METHODS: The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27664391/early-thrombin-formation-capacity-in-trauma-patients-and-association-with-venous-thromboembolism
#8
Stacy A Voils, Stephen J Lemon, Janeen Jordan, Paul Riley, Reginald Frye
Incidence of venous thromboembolism (VTE) in adult trauma patients is high despite mechanical and pharmacologic prophylaxis. We hypothesized that thrombin formation capacity as measured by calibrated automated thrombogram (CAT) is increased early in hospitalization and is associated with the development of VTE. METHODS: We conducted a prospective study in adult, critically ill trauma patients. Plasma was generated from whole blood samples collected within the first 3days of hospital admission...
November 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27639819/an-analysis-of-deep-vein-thrombosis-in-burn-patients-part-1-comparison-of-d-dimer-and-doppler-ultrasound-as-screening-tools
#9
COMPARATIVE STUDY
Rajeev B Ahuja, Priya Bansal, Gaurav S Pradhan, Manju Subberwal
INTRODUCTION: The high prevalence of deep vein thrombosis (DVT) reported in prospective studies and the unreliability of clinical diagnosis mandates prospective screening for DVT in burn patients. Our study seeks to compare D-dimer and Doppler ultrasound (DUS) in search for a practical, inexpensive and a reliable screening tool. METHODS: One hundred burn patients (inclusion criteria: 30-60% TBSA burn, >18 years of age, admitted within 48h of burn) were computer randomized into two equal groups...
December 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27633687/an-analysis-of-deep-vein-thrombosis-in-burn-patients-part-ii-a-randomized-and-controlled-study-of-thrombo-prophylaxis-with-low-molecular-weight-heparin
#10
RANDOMIZED CONTROLLED TRIAL
Rajeev B Ahuja, Priya Bansal, Gaurav S Pradhan, Manju Subberwal
INTRODUCTION: Morbidity and mortality from venous thrombo-embolism (VTE) remains a significant problem for trauma and medical patients and there are established guidelines for prophylaxis in these patients. However, the efficacy and safety of VTE prophylaxis in thermally injured patients continue to be elusive as it has never been studied in a prospective, randomized fashion. Selective use of VTE prophylaxis, for high risk patients, is practiced by some burn units even if objective evidence is lacking for majority of risk factors enunciated in burn patients...
December 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27627722/f11-rs2289252t-and-rs2036914c-polymorphisms-increase-the-activity-of-factor-xi-in-post-trauma-patients-with-fractures-despite-thromboprophylaxis
#11
Nan Song, Ai-Xian Tian, Jian-Min Zhang, Hong-Qiang Jiang, Jia-Cheng Zang, Xin-Long Ma
OBJECTIVE: To evaluate the association between F11 rs2289252, rs2036914 polymorphisms and the activity of clotting factor XI in post-trauma patients with fractures receiving routine anticoagulation therapy for deep venous thrombosis (DVT). METHODS: A case-control study involving 110 consecutive post-trauma patients with fractures and DVT in our hospital was conducted from April 2014 to October 2015; these patients comprised a DVT group. Another 40 sex- and age-matched patients with fractures but without DVT served as controls...
August 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27611117/-post-thrombotic-panic-syndrome-a-thematic-analysis-of-the-experience-of-venous-thromboembolism
#12
Rachael Hunter, Sarah Lewis, Simon Noble, Jaynie Rance, Paul D Bennett
OBJECTIVES: Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) is a serious, potentially traumatic, life-threatening condition and a major cause of mortality and morbidity. The aim of this study was to explore the patients' experiences of VTE and its psychosocial impact. METHODS: Audio-recorded semistructured interviews with a purposive sample of 12 participants who had experienced a first-time DVT or PE within the previous 6 months...
February 2017: British Journal of Health Psychology
https://www.readbyqxmd.com/read/27600864/combined-intermittent-pneumatic-leg-compression-and-pharmacological-prophylaxis-for-prevention-of-venous-thromboembolism
#13
REVIEW
Stavros K Kakkos, Joseph A Caprini, George Geroulakos, Andrew N Nicolaides, Gerard Stansby, Daniel J Reddy, Ioannis Ntouvas
BACKGROUND: It is generally assumed by practitioners and guideline authors that combined modalities (methods of treatment) are more effective than single modalities in preventing venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), or both. This is an update of the review first published in 2008. OBJECTIVES: The aim of this review was to assess the efficacy of combined intermittent pneumatic leg compression (IPC) and pharmacological prophylaxis versus single modalities in preventing venous thromboembolism...
September 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27592185/patients-with-multiple-traumatic-amputations-an-analysis-of-operation-enduring-freedom-joint-theatre-trauma-registry-data
#14
Brandon W Godfrey, Ashley Martin, Paul J Chestovich, Gordon H Lee, Nichole K Ingalls, Vilas Saldanha
INTRODUCTION: Improvised Explosive Devices (IED) are the primary wounding mechanism for casualties in Operation Enduring Freedom. Patients can sustain devastating traumatic amputations, which are unlike injuries seen in the civilian trauma sector. This is a database analysis of the largest patient registry of multiple traumatic amputations. METHODS: The Joint Theater Trauma Registry was queried for patients with a traumatic amputation from 2009 to 2012. Data obtained included the Injury Severity Score (ISS), Glasgow Coma Score (GCS), blood products, transfer from theatre, and complications including DVT, PE, infection (Acinetobacter and fungal), acute renal failure, and rhabdomyolysis...
January 2017: Injury
https://www.readbyqxmd.com/read/27565478/thromboembolic-complications-following-a-first-isolated-episode-of-superficial-vein-thrombosis-a-cross-sectional-retrospective-study
#15
Lauren N Bell, Richard L Berg, John R Schmelzer, Hong Liang, Joseph J Mazza, Rajan Kanth, Christopher L Bray, Calixto B Zaldivar, Steven H Yale
Superficial vein thrombosis (SVT) may be associated with complications such as venous thromboembolism (VTE) and recurrent SVT. The purpose of this study was to explore risk factors among patients with a first isolated episode of SVT (index SVT) involving upper and lower extremities and to estimate the prevalence of VTE complications within 1 year of index SVT. Retrospective chart review of electronic records at Marshfield Clinic in Wisconsin identified 381 subjects with a first isolated SVT diagnosis (male/female: 170/211; median age 59...
August 26, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27547945/hospital-variation-and-patient-characteristics-associated-with-vena-cava-filter-utilization
#16
Joshua D Brown, Jeffery C Talbert
INTRODUCTION: There is a wide variation in the use of vena cava filter (VCF). OBJECTIVE: This study assessed the hospital and patient characteristics associated with VCF use in deep vein thrombosis (DVT) and pulmonary embolism (PE). METHODS: Inpatient discharge data from all acute care hospitals with DVT/PE during 2008-2014 in Kentucky were used. Hierarchical logistic regression models were used to evaluate the relationships of study variables with VCF use...
January 2017: Medical Care
https://www.readbyqxmd.com/read/27525184/screening-for-referral-by-a-sports-physical-therapist-reveals-an-effort-thrombosis-in-a-collegiate-pitcher-a-case-report
#17
William R VanWye, Jase Pinerola, Karen Craig Ogle, Harvey W Wallmann
BACKGROUND AND PURPOSE: Screening for referral, regardless of setting, is the responsibility of all physical therapists. A serious condition that sports physical therapists may encounter is upper extremity (UE) deep venous thrombosis (DVT), which can result in the important and sometimes fatal complication of pulmonary embolism. CASE DESCRIPTION: A 22 year-old male right-hand dominant collegiate pitcher was referred for physical therapist evaluation and treatment secondary to acute right UE pain and swelling...
August 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27488490/anti-xa-guided-enoxaparin-thromboprophylaxis-reduces-rate-of-deep-venous-thromboembolism-in-high-risk-trauma-patients
#18
George A Singer, Gina Riggi, Charles A Karcutskie, Tanaz M Vaghaiwalla, Howard M Lieberman, Enrique Ginzburg, Nicholas Namias, Edward B Lineen
BACKGROUND: Appropriate prophylaxis against venous thromboembolism (VTE) remains undefined. This study evaluated an anti-Xa-guided enoxaparin thromboprophylaxis (TPX) protocol on the incidence of VTE in high-risk trauma patients based on Greenfield's Risk Assessment Profile (RAP) score. METHODS: This is a retrospective observational study of patients admitted to a trauma intensive care unit over a 12-month period. Patients were included if they received anti-Xa-guided enoxaparin TPX...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27433431/thromboembolic-disease-after-cervical-spine-surgery-a-review-of-5-405-surgical-procedures-and-matched-cohort-analysis
#19
Arjun S Sebastian, Bradford L Currier, Michelle J Clarke, Dirk Larson, Paul M Huddleston, Ahmad Nassr
STUDY DESIGN: Retrospective matched cohort analysis. OBJECTIVE: The majority of the literature on venous thromboembolism (VTE) after spine surgery is limited to studies of thoracolumbar surgery. Less is known regarding the incidence of VTE and associated risk factors following cervical spine surgery. METHODS: A total of 5,405 patients at our institution underwent cervical diskectomy, laminectomy, corpectomy, laminoplasty, or fusion between 1995 and 2012; 85 of the 5,405 patients (1...
August 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27315028/early-venous-thromboembolism-chemoprophylaxis-in-combat-related-penetrating-brain-injury
#20
R Michael Meyer, M Benjamin Larkin, Nicholas S Szuflita, Chris J Neal, Jeffrey M Tomlin, Rocco A Armonda, Jeffrey A Bailey, Randy S Bell
OBJECTIVE Traumatic brain injury (TBI) is independently associated with deep vein thrombosis (DVT) and pulmonary embolism (PE). Given the numerous studies of civilian closed-head injury, the Brain Trauma Foundation recommends venous thromboembolism chemoprophylaxis (VTC) after severe TBI. No studies have specifically examined this practice in penetrating brain injury (PBI). Therefore, the authors examined the safety and effectiveness of early VTC after PBI with respect to worsening intracranial hemorrhage and DVT or PE...
June 17, 2016: Journal of Neurosurgery
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