战斗士兵创伤后立即和早期静脉血栓栓塞的高发率

IF 3.7 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2025-06-17 DOI:10.1016/j.thromres.2025.109382

Ophir Freund , David Pelcman , Nimrod Orr Urtreger , Amir Bar-Shai , Cole Bendor , Avishai M Tsur , Ofer Almog , Michael Katsev , Dekel Golan , Daniel Starobin , Liran Levy , Shai Moshe Amor , Akiva Nachshon , Ori Wand , Michael Kassirer , Evgeni Gershman

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引用次数: 0

摘要

目的静脉血栓栓塞（VTE），包括肺栓塞（PE）和深静脉血栓形成（DVT），是一种已知的创伤并发症。战斗相关损伤具有独特的特征，可能会增加早期静脉血栓栓塞的发生率。因此，我们旨在评估铁之剑战争中战斗伤亡中即时和早期静脉血栓栓塞的发生率和特征。方法采用多中心回顾性研究，纳入2023年10月26日至12月31日转移至某创伤中心的战斗伤员。PE和DVT的诊断是基于影像报告，通过筛选所有的医疗记录。静脉血栓栓塞病例分为即刻（6小时）、早期（6 - 72小时）和晚期（72小时）。将入院前和住院特征与匹配的对照组进行比较。结果809例患者中，12例（1.5%）有立即或早期PE， 4例（0.5%）有立即或早期DVT。11例PE病例涉及胸部和/或肢体损伤，83%通过全身CT立即诊断。立即发生肺栓塞的患者胸部损伤、院前全血使用和止血带放置的发生率更高，尽管这些差异没有统计学意义。所有病例均发生下肢深静脉血栓形成。未见静脉血栓栓塞相关并发症或干预措施的报道。结论急诊和早期静脉血栓栓塞发生率高于既往报道，突出了先进的诊断工具和快速撤离对早期诊断的作用。需要进一步的研究来评估静脉血栓栓塞立即诊断对预后的影响。

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High rate of immediate and early post-traumatic venous thromboembolism in combat soldiers

Objective

Venous thromboembolism (VTE), which includes pulmonary embolism (PE) and deep vein thrombosis (DVT), is a known complication of trauma. Combat-related injuries have unique characteristics which might increase the rate of early VTE. For that reason, we aimed to evaluate the incidence and characteristics of immediate and early VTE among combat casualties during the Swords of Iron war.

Methods

A multicenter retrospective study including combat injured personnel evacuated to a trauma center between October 26 and December 31, 2023. PE and DVT were diagnosed based on imaging reports by screening all medical records. VTE cases were classified as immediate (<6 h), early (6–72 h), or late (>72 h). Pre- and in-hospital characteristics were compared to matched controls.

Results

Of 809 patients, 12 (1.5 %) had immediate or early PE and 4 (0.5 %) immediate or early DVT. Eleven PE cases involved chest and/or limb injuries, with 83 % diagnosed immediately by total body CT. Patients with immediate PE had higher rates of chest injuries, pre-hospital whole blood use, and tourniquet placement, though these differences were not statistically significant. DVT occurred in the injured limb in all cases. No VTE-related complications or interventions were reported.

Conclusion

Immediate and early VTE occurred at a higher rate than previously reported, highlighting the role of advanced diagnostic tools and rapid evacuation for early diagnosis. Further research is needed to assess the prognostic impact of immediate VTE diagnosis.

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.