Venous thromboembolism after penetrating chest trauma is not a cause of early death.
BACKGROUND: Venous thromboembolism has been recognized as a potentially life-threatening complication following major thoracic trauma. Little or no attention has been directed at the difference in rates of venous thromboembolism in subjects with penetrating and nonpenetrating chest trauma. METHODS: The reported experience with venous thromboembolism in subjects with chest trauma has not segregated the effect penetrating vs. closed chest trauma. The influence of long-term hospitalization to the formation deep vein thrombosis, pulmonary embolism or subsequent death. The present study evaluated the causes of early death occurring within 96 hours of hospitalization for penetrating chest trauma. The clinical records and autopsy reports of 32 individuals, who died within 96 hours of admission to hospital for penetrating chest trauma, were evaluated for the presence of deep vein thrombosis and pulmonary embolism. RESULTS: All 32 subjects were male with an average age of 31 years. Eighty percent were successfully resuscitated in the emergency room. Forty percent (40%) required an emergency or operating room thoracotomy. The initial revised trauma score (RTS) was below 4 in each case. Thirty-two percent (32%) of the patients died on the fourth day; 48% died between 1 and 3 days of admission and 20% died in the emergency room. None of the patients had any clinical signs or evidence of deep vein thrombosis or pulmonary embolism. Moreover, the autopsy findings were negative for deep vein thrombosis and pulmonary embolism. CONCLUSION: Deep vein thrombosis and pulmonary embolism is rarely a cause of death within the initial 96 hours of hospitalization in individuals sustaining penetrating chest trauma.