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大多数创伤相关的深静脉血栓在出院前得到解决。

A majority of trauma-related deep venous thromboses resolve prior to discharge.

机构信息

Division of Trauma, Department of Surgery, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, 200 West Arbor Dr., #8896, San Diego, CA, 92103-8896, USA.

出版信息

J Thromb Thrombolysis. 2023 Oct;56(3):368-374. doi: 10.1007/s11239-023-02863-1. Epub 2023 Jul 15.

Abstract

Post-traumatic DVTs present unique challenges in patient populations with specific high-risk injury patterns. Duplex ultrasound (US) can be used to assess evolution of DVTs and may guide treatment for high-risk patients. We hypothesized that many DVTs resolve during the initial admission. Weekly duplex US are ordered on all trauma inpatients regardless of prior DVT at our facility. We reviewed US and outcomes data on all patients with lower extremity DVTs at our Level I trauma center from January 2012-December 2021. 392 patients were diagnosed with lower extremity DVT by US. 261 (67%) patients received follow-up US with a mean time to repeat US of 6 days. Of these, 91 (35%) patients experienced DVT resolution prior to the first follow-up US, and 141 (54%) patients experienced resolution prior to discharge. Mean time to resolution was 10 days. Over 50% of DVTs resolve before discharge and are detected by US. Further studies and post-discharge follow-up are needed to determine if patients with resolved DVTs can be managed without therapeutic anticoagulation.

摘要

创伤后深静脉血栓形成(DVT)在具有特定高风险损伤模式的患者群体中存在独特的挑战。双功能超声(US)可用于评估 DVT 的演变,并可能为高危患者的治疗提供指导。我们假设许多 DVT 在初始住院期间得到解决。我们机构对所有创伤住院患者都进行每周一次的双功能 US 检查,无论之前是否有 DVT。我们回顾了 2012 年 1 月至 2021 年 12 月期间我们的一级创伤中心所有下肢 DVT 患者的 US 和结局数据。392 名患者通过 US 诊断为下肢 DVT。261 名(67%)患者接受了后续 US 检查,再次 US 的平均时间为 6 天。其中,91 名(35%)患者在首次随访 US 前 DVT 得到解决,141 名(54%)患者在出院前得到解决。平均解决时间为 10 天。超过 50%的 DVT 在出院前得到解决,并通过 US 检测到。需要进一步的研究和出院后的随访来确定是否可以在不进行治疗性抗凝的情况下管理已解决的 DVT 患者。

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