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Article
Upper Extremity Deep Venous Thrombosis Risk Factors, Associated Morbidity and Mortality in Trauma Patients
World Journal of Surgery
  • Mbaga S. Walusimbi, Wright State University
  • Avafia Y. Dossa
  • Kiran Faryar
  • Mary C. McCarthy, Wright State University
  • Ronald J. Markert, Wright State University - Main Campus
Document Type
Article
Publication Date
3-1-2022
Abstract

Background

The literature on upper extremity deep venous thrombosis (UEDVT) is not as abundant as that on lower extremities. This study aimed to identify the risk factors for UEDVT, associated mortality and morbidity in trauma patients and the impact of pharmacological prophylaxis therein. Methods

A 3-year retrospective review of patients admitted to a Level 1 trauma center was conducted. Patients aged 18 years or older who had experienced a traumatic event and had undergone an upper extremity ultrasound (UEUS) were included in the study. Multiple logistic regression was used to identify independent risk factors that contributed to UEDVT. Results

A total of 6,607 patients were admitted due to traumatic injuries during the study period, of whom 5.6% (373) had at least one UEUS during their hospitalization. Fifty-six (15%) were diagnosed with an UEDVT, as well as three non-fatal pulmonary emboli (PE) and four (7.1%) deaths, p = 0.03. Pharmacological prophylaxis with low-molecular-weight heparin (LMWH) or unfractionated heparin showed a protective effect against UEDVT; among the patients positive for UEDVT, 14 of 186 patients (7.5%) received LMWH, while 42 of 195 (21.5%) did not receive LMWH (p < 0.001). Multiple logistic regression revealed that the presence of upper extremity fractures, peripherally inserted central catheter (PICC) lines, and traumatic brain injury (TBI) were independent risk factors for UEDVT. Conclusions

UEDVT are associated with a higher mortality. The presence of upper extremity fractures, PICC lines, and TBI were independent risk factors for UEDVTs. Further, pharmacological prophylaxis reduces the risk of UEDVT.

DOI
10.1007/s00268-021-06383-y
Citation Information
Mbaga S. Walusimbi, Avafia Y. Dossa, Kiran Faryar, Mary C. McCarthy, et al.. "Upper Extremity Deep Venous Thrombosis Risk Factors, Associated Morbidity and Mortality in Trauma Patients" World Journal of Surgery Vol. 46 Iss. 3 (2022) p. 561 - 567 ISSN: 0364-2313
Available at: http://works.bepress.com/mbaga_walusimbi/36/