Prevalence of Venous Thromboembolism in Trauma Patients in a Private Tertiary Care Hospital

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Wittawas Sriprayoon
Ekkit Surakan
Wassana Siriwanitchaphan


OBJECTIVES: To study the prevalence of venous thromboembolism (VTE) in trauma patients receiving inpatient care at Bangkok Hospital Headquarters (BHQ).
MATERIAL AND METHODS: A retrospective observational study in adult trauma patients (age ≥ 15 years) admitted at BHQ from 2016 to 2018. The collected data were diagnosis of VTE, gender, age, ethnicity, VTE risk score, Injury Severity Score (ISS), the onset of VTE, and patient care modalities including operative or non-operative management, need for intensive care and need for ventilator support.
RESULT: A total of 2,548 trauma patients were admitted at BHQ from January 1, 2016 to December 31, 2018. Thirty-one patients developed VTE (1.22%), 29 cases had deep vein thrombosis (DVT) and 2 cases had DVT with pulmonary embolism (PE). There were twenty-one male patients and ten female patients in the VTE group. Fifteen patients in the VTE group were older than 65 years (48%). The prevalence of VTE was 0.54% in Thai patients, and 2.43% in non-Thai patients. Twenty-nine patients in the VTE group had high VTE risk. Four patients had diagnosis of VTE prior to admission at BHQ and 13 cases had been diagnosed within 48 hours of admission. The patients with higher severity of injury (higher ISS) had higher risk for VTE (p < 0.001). Twenty-four cases in the VTE group needed surgical management. Seventeen cases required intensive care and 7 cases needed ventilator support, not related to the presence of PE. Six patients developed VTE despite prevention.
CONCLUSION: The prevalence of VTE in adult trauma patients in BHQ is 1.22%. A significant association between VTE and the severity of injury suggests that we should pay attention to this specific groups of patients for early VTE prophylaxis and detection. 


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Sriprayoon W, Surakan E, Siriwanitchaphan W. Prevalence of Venous Thromboembolism in Trauma Patients in a Private Tertiary Care Hospital. BKK Med J [Internet]. 2020Feb.25 [cited 2020Apr.4];16(1):13. Available from:
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1. Heit JA, Silverstein MD, Mohr DN, et al. Risk factors for deep vein thrombosis and pulmonary embolism: A population- based case-control study. Arch Intern Med 2000;160:809-15.

2. Nastasi AJ, Canner JK, Lau BD, et al. Characterizing the relationship between age and venous thromboembolism in adult trauma patients: findings from the National Trauma Data Bank and the National Inpatient Sample. J Surg Res 2017;216:115-22.

3. Paffrath T, Wafaisade A, Lefering R, et al. Venous thromboembolism after severe trauma: incidence, risk factors and outcome. Injury 2010;41(1):97-101.

4. Akaraborworn O, Sangthong B, Thongkhao K, et al. Adherence to guideline of venous thromboembolism prophylaxis in a level 1 Trauma center in Thailand. Arch Trauma Res 2018;7:11-4

5. Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon 2005;51(2-3):70–78.

6. Copes WS, Champion HR, Sacco WJ, et al. The Injury Severity Score revisited. Trauma 1998;28 (1):69–77.

7. Geerts WH, Code KI, Jay RM, et al. A prospective study of venous thromboembolism after major trauma. N Engl J Med 1994; 331(24):1601-6.

8. Kelly J, Hunt BJ. Do anticoagulants improve survival in patients presenting with venous thromboembolism? J Intern Med 2003; 254(6):527-39.

9. Carson JL, Kelley MA, Duff A, et al. The clinical course of pulmonary embolism. TEN Engl J Med 1992; 326(19):1240-5.

10. Kahn SR, Comerota AJ, Cushman M, et al. The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association. American Heart Association Council on Peripheral Vascular Disease, Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing. Circulation 2014; 130(18):1636-61.

11. Liew NC, Alemany GV, Angchaisuksiri P. Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. Int Angiol 2017;36(1):1-20.

12. Berndtson AE, Costantini TW, Smith AM, et al. Does sex matter? Effects on venous thromboembolism risk in screened trauma patients. J Trauma Acute Care Surg 2016; 81: 493–9

13. Kim DY, Kobayashi L, Barmparas G, et al. Venous thromboembolism in the elderly: the result of comorbid conditions or a consequence of injury? J Trauma Acute Care Surg 2012;72(5):1286-91.

14. White RH, Keenan CR. Effects of race and ethnicity on the incidence of venous thromboembolism. Thromb Res 2009; 123(Suppl 4): S11-7.

15. Zakai NA, McClure LA. Racial differences in venous thromboembolism. J Thromb Haemost 2011;9: 1877-82.

16. Wong TH, Koh MP, Ng J. Symptomatic venous thromboembolism in Asian major trauma patients: incidence, presentation and risk factors. Eur J Trauma Emerg Surg 2013; 39: 495-500.

17. Yumoto T, Hiromichi N, Yamakawa Y, et al. Venous throm- boembolism in major trauma patients: a single-center retrospective cohort study of the epidemiology and utility of D-dimer for screening. Acute Med Surg 2017;4(4): 394-400.

18. Hamada SR, Espina C, Guedj T, et al. High level of venous thromboembolism in critically ill trauma patients despite early and well-driven thromboprophylaxis protocol. Ann Intensive Care 2017; 7:97.