PULMONARY ARTERY THROMBOSIS IN TRAUMA: NOT AS DEADLY AS PREVIOUSLY THOUGHT. jack.carlson@health.nsw.gov.au

 

PULMONARY ARTERY THROMBOSIS IN TRAUMA: NOT AS DEADLY AS PREVIOUSLY THOUGHT.

5

Australia

Oral only

Seminal reports suggest that trauma patients are prone to in-situ pulmonary artery thrombosis (PAT), distinct to deep venous thrombosis-associated pulmonary embolism. This study aims to characterize the incidence, risk factors and clinical outcomes of PAT.

12-month (year-2019) retrospective study was performed in a Level-1 Trauma Centre. All trauma resuscitation bay CT scans were reviewed for the presence of PAT (primary outcome). Variables collected: age, sex, injury severity score (ISS), abbreviated injury scale (AIS), vital signs and lactate at presentation. Secondary outcomes were mortality, hospital and ICU length of stay (LOS), ventilator days (VD), respiratory failure (RF), and multiple organ failure (MOF). Statistical analysis was performed with Kruskal-Wallis rank sum and Fisher’s exact tests.

From 597 major trauma admissions, 278 (46.6%) underwent pan-scans (age:48.6; 76.6%male, medianISS 21). 43/278(15.5%) had PAT (Age:48.5, 83%male, medianISS 22). PAT and non-PAT patients were not different in age, sex, ISS, AIS-chest (2.23 vs 2.61, p=0.122), but had higher extremity-AIS (2.09 vs 1.38, p=0.004), external-AIS (0.84 vs 0.51, p=0.006), lactate (3.40 vs 2.30, p=0.001) and lower systolic blood pressure (120 vs 128mmHg, p=0.004). PAT patients’ mortality (14% vs 7.3%, p=0.144), hospital-LOS, ICU-LOS and VD was not higher. PAT patients had more RF (20.9% vs 8.6%, p=0.027) but not MOF (7% vs 5%).

PAT is frequently identified on initial trauma imaging but is not associated with demographics, ISS, MOF, LOS or mortality. This study will inform prospective studies on power and design to identify the impact of PAT on trauma mortality.