Park Hyung Su, Hyun Sung Youl, Choi Woo Sung, Cho Jin-Seong, Jang Jae Ho, Choi Jea Yeon
Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Department of Traumatology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
J Trauma Inj. 2022 Sep;35(3):159-167. doi: 10.20408/jti.2021.0052. Epub 2022 Jun 10.
The aim of this study was to investigate the epidemiology of trauma inpatients with venous thromboembolism (VTE) symptoms diagnosed using computed tomographic angiography (CTA) in Korea.
In total, 7,634 patients admitted to the emergency department of Gachon University Gil Medical Center, a tertiary hospital, and hospitalized between July 1, 2018 and December 31, 2020 were registered for this study. Of these patients, 278 patients who underwent CTA were enrolled in our study.
VTE was found in 120 of the 7,634 patients (1.57%), and the positive diagnosis rate of the 278 patients who underwent CTA was 43.2% (120 of 278). The incidence of VTE was statistically significantly higher among those with severe head and neck injuries (Abbreviated Injury Scale, 3-5) than among those with nonsevere head and neck injuries (Abbreviated Injury Scale, 0-2; P=0.038). In a subgroup analysis, the severe and nonsevere head and neck injury groups showed statistically significant differences in known independent risk factors for VTE. In logistic regression analysis, the adjusted odds ratio of severe head and neck injury (Abbreviated Injury Scale, 3-5) for VTE was 1.891 (95% confidence interval, 1.043-3.430).
Trauma patients with severe head and neck injuries are more susceptible to VTE than those with nonsevere head and neck injuries. Thus, physicians must consider CTA as a priority for the diagnosis of VTE in trauma patients with severe head and neck injuries who show VTE-associated symptoms.
本研究旨在调查韩国使用计算机断层血管造影(CTA)诊断的有静脉血栓栓塞(VTE)症状的创伤住院患者的流行病学情况。
共有7634名患者入住加图立大学吉尔医学中心急诊科,该中心为三级医院,本研究纳入了2018年7月1日至2020年12月31日期间住院的患者。其中,278名接受CTA检查的患者被纳入本研究。
7634名患者中有120名(1.57%)发现VTE,278名接受CTA检查的患者的阳性诊断率为43.2%(278名中的120名)。重度头颈部损伤患者(简明损伤定级标准,3 - 5级)的VTE发生率在统计学上显著高于非重度头颈部损伤患者(简明损伤定级标准,0 - 2级;P = 0.038)。在亚组分析中,重度和非重度头颈部损伤组在已知的VTE独立危险因素方面存在统计学显著差异。在逻辑回归分析中,重度头颈部损伤(简明损伤定级标准,3 - 5级)发生VTE的调整优势比为1.891(95%置信区间,1.043 - 3.430)。
重度头颈部损伤的创伤患者比非重度头颈部损伤的患者更容易发生VTE。因此,对于出现VTE相关症状的重度头颈部损伤的创伤患者,医生必须优先考虑将CTA作为VTE的诊断方法。