Insights into VTE risk in trauma patients: an observational study in an Irish trauma patient population.

Background: The rate of VTE in trauma patients varies significantly in the reported literature. We aimed to determine the incidence of VTE in trauma patients in a trauma-receiving hospital over a 7-year period. We sought to evaluate the timing and nature of VTE events and explore the patterns of co-occurrence between PE and DVT, while factoring in clinical care and death outcome.

Methods: Retrospective review of consecutive trauma patients ≥ 18 years admitted between January 2014 and December 2020. Data were extracted from the TARN database, picture archiving and communication system, and hospital records. The primary outcome was VTE incidence. Latent class analysis was used to uncover cross combinations of clinical management and VTE outcomes, yielding subgroups of trauma patients. Subgroups were compared for demographic and clinical characteristics.

Findings: Seventy-three VTE were observed-incidence of 0.0036 cases/people-year (95% CI 0.0 to 3.69). VTE ( +) group consisted mostly of males (75%), had an advanced age, had higher injury severity scores, and had increased length of stay. Most patients (64%) developed a PE only. Most DVT (64%) were proximal. Two subgroups had a high probability of PE/low probability of DVT and two a high probability of DVT/low-to-moderate probability of PE. Subgroup comparisons showed differences in the clinical characteristics which were statistically inconclusive.

Conclusion: This is the largest study of VTE incidence in Irish trauma patients and the first to delineate VTE risk in a trauma population. These findings urge reconsideration of VTE risk in trauma patients and implementation of prevention strategies.