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A 20-year retrospective analysis of deep venous thrombosis and pulmonary embolism among combat casualties requiring damage-control laparotomy at US military Role 2 surgical units.
Cobler-Lichter, Michael D; Collie, Brianna L; Delamater, Jessica M; Shagabayeva, Larisa; Lyons, Nicole B; Bustillos, Luciana Tito; Namias, Nicholas; Stallings, Jonathan D; Gross, Kirby R; Buzzelli, Mark D; Gurney, Jennifer; Proctor, Kenneth G; Wetstein, Paul J.
Afiliación
  • Cobler-Lichter MD; From the Division of Trauma, Surgical Critical Care and Burns (M.D.C.-L., B.L.C., J.M.D., L.S., N.B.L., L.T.B., N.N., M.D.B., K.G.P., P.J.W.), Daughtry Family Department of Surgery, University of Miami Miller School of Medicine; Jackson Memorial Hospital Ryder Trauma Center (M.D.C.-L., B.L.C., J.M.D., L.S., N.B.L., L.T.B., N.N., M.D.B., K.G.P., P.J.W.); US Army Trauma Training Center (M.D.C.-L., B.L.C., J.M.D., L.S., N.B.L., L.T.B., N.N., M.D.B., K.G.P., P.J.W.), Miami, Florida; Joint Trauma Sys
J Trauma Acute Care Surg ; 97(2S Suppl 1): S55-S59, 2024 Aug 01.
Article en En | MEDLINE | ID: mdl-38787627
ABSTRACT

BACKGROUND:

Combat casualties receiving damage-control laparotomy at forward deployed, resource-constrained US military Role 2 (R2) surgical units require multiple evacuations, but the added risk of venous thromboembolism (VTE) in this population has not been defined. To fill this gap, we retrospectively analyzed 20 years of Department of Defense Trauma Registry data to define the VTE rate in this population.

METHODS:

Department of Defense Trauma Registry from 2002 to 2023 was queried for US military combat casualties requiring damage-control laparotomy at R2. All deaths were excluded in subsequent analysis. Rates of VTE were assessed, and subgroup analysis was performed on patients requiring massive transfusion.

RESULTS:

Department of Defense Trauma Registry (n = 288) patients were young (mean age, 25 years) and predominantly male (98%) with severe (mean Injury Severity Score, 26), mostly penetrating injury (76%) and high mortality. Venous thromboembolism rate was high 15.8% (DVT, 10.3%; pulmonary embolism, 7.1%). In the massively transfused population, the VTE rate was even higher (26.7% vs. 10.2%, p < 0.001).

CONCLUSION:

This is the first report that combat casualties requiring damage-control laparotomy at R2 have such high VTE rates. Therefore, for military casualties, we propose screening ultrasound upon arrival to each subsequent capable echelon of care and low threshold for initiating thromboprophylaxis. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Sistema de Registros / Trombosis de la Vena / Laparotomía / Personal Militar Límite: Adult / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Trauma Acute Care Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Sistema de Registros / Trombosis de la Vena / Laparotomía / Personal Militar Límite: Adult / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Trauma Acute Care Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos