Journal of Emergencies, Trauma, and Shock

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 10  |  Issue : 2  |  Page : 60--63

Trauma patients warrant upper and lower extremity venous duplex ultrasound surveillance


Alonso Andrade1, Alan H Tyroch1, Susan F McLean1, Jody Smith1, Alex Ramos2 
1 Department of Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
2 Trauma Center, University Medical Center of El Paso, El Paso, Texas, USA

Correspondence Address:
Alonso Andrade
Department of Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, Texas
USA

Background: Due to the high incidence of thromboembolic events (deep venous thrombosis [DVT] and pulmonary embolus [PE]) after injury, many trauma centers perform lower extremity surveillance duplex ultrasounds. We hypothesize that trauma patients are at a higher risk of upper extremity DVTs (UEDVTs) than lower extremity DVTs (LEDVTs), and therefore, all extremities should be evaluated. Materials and Methods: A retrospective chart and trauma registry review of Intensive Care Unit trauma patients with upper and LEDVTs detected on surveillance duplex ultrasound from January 2010 to December 2014 was carried out. Variables reviewed were age, gender, injury severity score, injury mechanism, clot location, day of clot detection, presence of central venous pressure catheter, presence of inferior vena cava filter, mechanical ventilation, and fracture. Results: A total of 136 patients had a DVT in a 5-year period: upper - 71 (52.2%), lower - 61 (44.9%), both upper and lower - 4 (2.9%). Overall, 75 (55.2%) patients had a UEDVT. Upper DVT vein: Brachial (62), axillary (26), subclavian (11), and internal jugular (10). Lower DVT vein: femoral (58), popliteal (14), below knee (4), and iliac (2). 10.3% had a PE: UEDVT - 5 (6.7%) and LEDVT - 9 (14.8%) P = 0.159. Conclusions: The majority of the DVTs in the study were in the upper extremities. For trauma centers that aggressively screen the lower extremities with venous duplex ultrasound, surveillance to include the upper extremities is warranted.


How to cite this article:
Andrade A, Tyroch AH, McLean SF, Smith J, Ramos A. Trauma patients warrant upper and lower extremity venous duplex ultrasound surveillance.J Emerg Trauma Shock 2017;10:60-63


How to cite this URL:
Andrade A, Tyroch AH, McLean SF, Smith J, Ramos A. Trauma patients warrant upper and lower extremity venous duplex ultrasound surveillance. J Emerg Trauma Shock [serial online] 2017 [cited 2017 May 27 ];10:60-63
Available from: http://www.onlinejets.org/article.asp?issn=0974-2700;year=2017;volume=10;issue=2;spage=60;epage=63;aulast=Andrade;type=0