Early pulmonary embolism after injury: A different clinical entity?

Background: We sought to characterize pulmonary embolism (PE) occurring early after injury. We hypothesized that early PE may represent a different clinical entity than those occurring later in the post-injury period. Methods: All trauma patients diagnosed with PE from 2005 to 2010 were examined. PEs diagnosed within 72 h of admission were compared against those occurring later. Results: 19 out of 54 PEs were diagnosed early. Early PE patients had a higher rate of lower extremity fractures, a lower mean injury severity score, and a lower average length of stay. Early PE patients had a shorter average time to start of chemical prophylaxis, were less likely to have had a femoral line, and less likely to have operative intervention under general anaesthesia. Conclusions: Early PE after trauma may occur with different underlying pathophysiology than previously thought. Further study is indicated as this has implications concerning the prevention of PE in trauma patients. (C) 2013 Elsevier Ltd. All rights reserved.