Skip to main content

Main menu

  • Latest content
    • Latest content
  • Archive
  • About the journal
    • About the journal
    • Editorial board
    • Information for authors
    • FAQs
    • Thank you to our reviewers
    • The American Association for the Surgery of Trauma
  • Submit a paper
    • Online submission site
    • Information for authors
  • Email alerts
    • Email alerts
  • Help
    • Contact us
    • Feedback form
    • Reprints
    • Permissions
    • Advertising
  • BMJ Journals

User menu

  • Login

Search

  • Advanced search
  • BMJ Journals
  • Login
  • Facebook
  • Twitter
TSACO

Advanced Search

  • Latest content
    • Latest content
  • Archive
  • About the journal
    • About the journal
    • Editorial board
    • Information for authors
    • FAQs
    • Thank you to our reviewers
    • The American Association for the Surgery of Trauma
  • Submit a paper
    • Online submission site
    • Information for authors
  • Email alerts
    • Email alerts
  • Help
    • Contact us
    • Feedback form
    • Reprints
    • Permissions
    • Advertising
Open Access

Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention

Asanthi Ratnasekera, Odessa Pulido, Sandra Durgin, Sharon Nichols, Alicia Lozano, Danielle Sienko, Alexandra Hanlon, Niels D. Martin
DOI: 10.1136/tsaco-2020-000468 Published 11 June 2020
Asanthi Ratnasekera
1 Department of Surgery, Crozer-Keystone Health System, Upland, Pennsylvania, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Asanthi Ratnasekera
Odessa Pulido
2 Department of Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sandra Durgin
1 Department of Surgery, Crozer-Keystone Health System, Upland, Pennsylvania, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sharon Nichols
1 Department of Surgery, Crozer-Keystone Health System, Upland, Pennsylvania, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Alicia Lozano
3 Department of Statisitics, Virginia Polytechnic Institute and State University, Center for Biostatistics and Health Data Science, Roanoke, Virginia, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Danielle Sienko
3 Department of Statisitics, Virginia Polytechnic Institute and State University, Center for Biostatistics and Health Data Science, Roanoke, Virginia, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Alexandra Hanlon
3 Department of Statisitics, Virginia Polytechnic Institute and State University, Center for Biostatistics and Health Data Science, Roanoke, Virginia, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Niels D. Martin
4 Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1

    Flow diagram of patient selection. Two hundred and seven patients matched the inclusion criteria. The DVT rates were compared in patients with isolated femoral/popliteal arterial injuries and patients with concomitant femoral/popliteal venous and arterial injuries. DVT, deep venous thrombosis; PTOS, Pennsylvania Trauma Outcome Study.

Tables

  • Figures
  • Table 1

    Patient characteristics by femoral or popliteal arterial and venous injuries (n=207)

    CharacteristicOverall sample
    (n=207)
    Patients with isolated arterial injuries
    (n=131)
    Patients with concomitant arterial and venous injuries
    (n=76)
    P value*
    Age, median (Q1, Q3)26 (22, 35)27 (22, 37)25 (22, 34)0.6819
    Gender, n (%)   0.7866
     Male192 (92.8)122 (93.1)70 (92.1)
     Female15 (7.2)9 (6.9)6 (7.9)
    Race, n (%)(n=185)(n=116)(n=69)0.6324
     White42 (22.7)27 (23.3)15 (21.7)
     Black134 (72.4)83 (71.5)51 (73.9)
     Asian3 (1.6)3 (2.6)0 (0.0)
     Other6 (3.3)3 (2.6)3 (4.4)
    ISS, median (Q1, Q3)10 (10, 17)10 (10, 17)14 (10, 17)0.1701
    TRISS, median (Q1, Q3)0.9868 (0.956, 0.990)
    (n=193)
    0.988 (0.970, 0.990)
    (n=124)
    0.982 (0.908, 0.990)
    (n=69)
    0.0177
    AIS, median (Q1, Q3)3 (3, 4)3 (3, 4)3 (3, 4)0.0639
    SBP, mean (SD)109.14 (38.9)
    (n=203)
    113.1 (35.5)
    (n=129)
    102.2 (43.7)
    (n=74)
    0.0705
    HR, mean (SD)96.5 (33.8)
    (n=204)
    95.16 (30.9)
    (n=130)
    98.85 (38.5)
    (n=74)
    0.4817
    GCS, median (Q1, Q3)15 (14, 15)
    (n=205)
    15 (15, 15)
    (n=130)
    15 (6, 15)
    (n=75)
    0.0095
    Blood unit, median (Q1, Q3)0 (0, 2)
    (n=205)
    0 (0, 1)
    (n=129)
    1 (0, 2.5)0.0002
    MTP, n (%)26 (23.9)
    (n=109)
    9 (14.1)
    (n=64)
    17 (37.8)
    (n=45)
    0.0060
    ICU LOS, median (Q1, Q3)2 (1, 3)1 (0, 3)2 (1, 4)0.0016
    Step-down LOS, median (Q1, Q3)0 (0, 0)0 (0, 0)0 (0, 0)0.3674
    Ventilator days, median (Q1, Q3)0 (0, 1)0 (0, 1)1 (0, 1)0.0005
    Hospital LOS, median (Q1, Q3)9 (4, 16)8 (4, 15)11 (6, 18.5)0.0124
    DVT, n (%)14 (6.8)4 (3.1)10 (13.2)0.0083
    Mortality, n (%)16 (7.7)8 (6.1)8 (10.5)0.2856
    Procedure, n (%)   0.5267
     Endovascular repair41 (19.8)30 (22.9)11 (14.5)
     Open repair29 (14.0)18 (13.7)11 (14.5)
     Combined approach55 (26.6)34 (26.0)21 (27.6)
     Neither82 (39.6)49 (37.4)33 (43.4)
    Vascular injury repair >24 hours, n (%)3 (2.9)
    (n=102)
    2 (3.9)
    (n=51)
    1 (2.0)
    (n=51)
    >0.9999
    Vascular injury repair <24 hours, n (%)95 (96.9)
    (n=98)
    47 (95.9)
    (n=49)
    48 (98.0)
    (n=49)
    >0.9999
    Revision operations, n (%)6 (2.9)3 (2.3)3 (4.0)0.6712
    • *P values based on non-parametric Wilcoxon rank-sum tests or parametric two-sample t-tests for continuous variables and Fisher’s exact tests for categorical variable.

    • AIS, Abbreviated Injury Scale; DVT, deep venous thrombosis; GCS, Glasgow Coma Scale; HR, heart rate; ICU, intensive care unit; ISS, Injury Severity Score; LOS, length of stay; MSP, massive transfusion protocol; SBP, systolic blood pressure; TRISS, Trauma and Injury Severity Score.

  • Table 2

    Patient characteristics for those with femoral or popliteal arterial and venous injuries with and without DVTs (n=207)

    CharacteristicOverall sample
    (n=207)
    No DVT
    (n=193)
    DVT
    (n=14)
    P value*
    Age, median (Q1, Q3)26 (22, 35)27 (22, 35)23 (22, 45)0.7199
    Gender, n (%)   >0.9999
     Male192 (92.8)179 (92.8)13 (92.9)
     Female15 (7.2)14 (7.2)1 (7.1)
    Race, n (%)(n=185)(n=172)(n=13)>0.9999
     White42 (22.7)39 (22.7)3 (23.1)
     Black134 (72.4)124 (72.1)10 (76.9)
     Asian3 (1.6)3 (1.7)0 (0.0)
     Other6 (3.3)6 (3.5)0 (0.0)
    ISS, median (Q1, Q3)10 (10, 17)10 (10, 17)17 (10, 27)0.0911
    TRISS, median (Q1, Q3)0.9868 (0.956, 0.990)
    (n=193)
    0.987 (0.958, 0.990)
    (n=179)
    0.974 (0.908, 0.982)0.0416
    AIS, median (Q1, Q3)3 (3, 4)3 (3, 4)3.5 (3, 4)0.2680
    SBP, mean (SD)109.14 (38.9)
    (n=203)
    109.38 (39.6)
    (n=189)
    105.93 (29.4)0.7498
    HR, mean (SD)96.5 (33.8)
    (n=204)
    95.28 (33.8)
    (n=191)
    114.38 (28.8)
    (n=13)
    0.0484
    GCS, median (Q1, Q3)15 (14, 15)
    (n=205)
    15 (14, 15)
    (n=191)
    15 (14, 15)0.7438
    Blood unit, median (Q1, Q3)0 (0, 2)
    (n=205)
    0 (0, 2)
    (n=191)
    0.5 (0, 2)0.3323
    MTP, n (%)26 (23.9)
    (n=109)
    21 (20.4)
    (n=103)
    5 (83.3)
    (n=6)
    0.0028
    ICU LOS, median (Q1, Q3)2 (1, 3)1 (1, 3)5 (2, 7)0.0008
    Step-down LOS, median (Q1, Q3)0 (0, 0)0 (0, 0)0 (0, 0)0.6503
    Ventilator days, median (Q1, Q3)0 (0, 1)0 (0, 1)1.5 (1, 2)0.0007
    Hospital LOS, median (Q1, Q3)9 (4, 16)9 (4, 15)17.5 (12, 23)0.0013
    Mortality, n (%)16 (7.7)15 (7.7)1 (7.1)>0.9999
    Procedure, n (%)  0.2370
     Endovascular repair41 (19.8)39 (20.2)2 (14.3)
     Open repair29 (14.0)25 (13.0)4 (28.6)
     Hybrid repair55 (26.6)50 (25.9)5 (35.7)
     No intervention82 (39.6)79 (40.9)3 (21.4)
    • *P values based on non-parametric Wilcoxon rank-sum tests or parametric two-sample t-tests for continuous variables and Fisher’s exact tests for categorical variables.

    • AIS, Abbreviated Injury Scale; DVT, deep venous thrombosis; GCS, Glasgow Coma Scale; HR, heart rate; ICU, intensive care unit; ISS, Injury Severity Score; LOS, length of stay; MTP, massive transfusion protocol; SBP, systolic blood pressure; TRISS, Trauma and Injury Severity Score.

  • Table 3

    Patient characteristics with isolated arterial injuries with and without DVTs (n=131)

    CharacteristicNo DVT
    (n=127)
    DVT
    (n=4)
    P value*
    Age, median (Q1, Q3)27 (22, 36)30.5 (21, 45)0.8302
    Gender, n (%)  >0.9999
     Male118 (92.9)4 (100)
     Female9 (7.1)0 (0)
    Race, n (%)
    (n=69)
    (n=60)(n=9)0.3969
     White25 (22.3)2 (50.0)
     Black81 (72.3)2 (50.0)
     Asian3 (2.7)0 (0)
     Other3 (2.7)0 (0)
    ISS, median (Q1, Q3)10 (10, 17)24.5 (13, 33)0.1793
    TRISS, median (Q1, Q3)0.989 (0.972, 0.990)
    (n=120)
    0.860 (0.562, 0.955)0.1282
    AIS, median (Q1, Q3)3 (3, 4)4 (3.5, 4)0.1054
    SBP, median (Q1, Q3)118 (102, 135)
    (n=125)
    92.5 (88.5, 108.5)0.1149
    HR, median (Q1, Q3)94 (80, 114)
    (n=126)
    126 (101, 147)
    (n=9)
    0.0564
    GCS, median (Q1, Q3)15 (15, 15)
    (n=126)
    12.5 (7, 14.5)0.0143
    Blood unit, median (Q1, Q3)0 (0, 1)
    (n=125)
    1 (0, 2.5)0.2949
    MTP, n (%)8 (12.9)
    (n=62)
    1 (50)
    (n=2)
    0.2634
    ICU LOS, median (Q1, Q3)1 (0, 3)3 (2.5, 5)0.0585
    Step-down LOS, median (Q1, Q3)0 (0, 0)0 (0, 1)0.8627
    Ventilator days, median (Q1, Q3)0 (0, 1)2 (1.5, 2)0.0020
    Hospital LOS, median (Q1, Q3)8 (4, 15)17.5 (10.5, 23)0.0664
    Mortality, n (%)8 (6.3)0 (0.0)>0.9999
    Procedure, n (%)  0.0105
     Endovascular repair30 (23.6)0 (0.0)
     Open repair15 (11.8)3 (75.0)
     Hybrid repair34 (26.8)0 (0.0)
     No intervention48 (37.8)1 (25.0)
    • *P values are based on non-parametric Wilcoxon two-sample tests for continuous variables and Fisher’s exact tests for categorical variables.

    • AIS, Abbreviated Injury Scale; DVT, deep venous thrombosis; GCS, Glasgow Coma Scale; HR, heart rate; ICU, intensive care unit; ISS, Injury Severity Score; LOS, length of stay; MTP, massive transfusion protocol; SBP, systolic blood pressure; TRISS, Trauma and Injury Severity Score.

  • Table 4

    Patient characteristics with isolated femoral and popliteal arterial injuries by repair technique (n=131)

    Endovascular repair
    (n=30)
    Open repair
    (n=18)
    Hybrid repair
    (n=34)
    No intervention*(n=49)P value†
    2 groups
    P value‡
    3 groups
    Age, median (Q1, Q3)24 (21, 31)28 (21, 37)24.5 (21, 34)30 (24, 39)0.26630.5033
    Gender, n (%)    0.28240.3623
     Male26 (86.7)18 (100)31 (91.2)47 (95.9)
     Female4 (13.3)0 (0)3 (8.8)2 (4.1)
    Race, n (%) (n=116)(n=27) (n=31)(n=40)0.18830.4000
     White6 (22.2)8 (44.4)6 (19.4)7 (17.5)
     Black20 (74.1)10 (55.6)23 (74.2)30 (75.0)
     Asian0 (0.0)0 (0.0)1 (3.2)2 (5.0)
     Other1 (3.7)0 (0.0)1 (3.2)1 (2.5)
    ISS, median (Q1, Q3)10.5 (10, 17)17 (9, 24)10 (9, 16)10 (10, 17)0.77980.2582
    TRISS, median (Q1, Q3) (n=124)0.99 (0.98, 0.99)0.99 (0.74, 0.99)
    (n=16)
    0.99 (0.98, 0.99)0.99 (0.96, 0.99)
    (n=44)
    0.78990.2674
    AIS, median (Q1, Q3)3 (3, 3)3.5 (3, 4)3 (3, 3)3 (3, 4)0.28290.3531
    SBP, median (Q1, Q3) (n=129)117 (107, 130)108.5 (96, 128)123 (112, 135)118 (90, 140)
    (n=47)
    0.46880.2590
    HR, median (Q1, Q3) (n=130)89.5 (77, 108)95.5 (90, 115)94 (82, 115)98.5 (76.5, 117)
    (n=48)
    0.18650.3921
    GCS, median (Q1, Q3) (n=130)15 (15, 15)15 (4, 15)
    (n=17)
    15 (15, 15)15 (15, 15)0.06860.1481
    Blood unit, median (Q1, Q3)
    (n=129)
    0 (0, 0)0 (0, 2)0 (0, 1)
    (n=33)
    0 (0, 1)
    (n=48)
    0.17850.3661
    MTP, n (%) (n=64)1 (5.6)
    (n=18)
    1 (50)
    (n=2)
    0 (0)
    (n=1)
    7 (16.3)
    (n=43)
    0.19470.2714
    ICU LOS, median (Q1, Q3)1 (0, 3)2 (2, 5)2 (1, 4)1 (0, 1)0.01850.0403
    Step-down LOS,
    median (Q1, Q3)
    0 (0, 2)0 (0, 0)0 (0, 0)0 (0, 0)0.04420.0985
    Ventilator days,
    median (Q1, Q3)
    0 (0, 0)1 (0, 3)0 (0, 1)0 (0, 0)0.00200.0053
    Hospital LOS,
    median (Q1, Q3)
    6 (4, 11)11.5 (5, 20)12 (8, 16)4 (3, 9)0.10260.0150
    • *The no intervention group was not included in any of the significance testing.

    • †P values were used to examine differences between the open and endovascular repair groups, and were based on non-parametric Wilcoxon rank-sum tests or parametric two-sample t-tests for continuous variables and Fisher’s exact tests for categorical variables.

    • ‡P values were used to examine differences between all three repair groups (endovascular, open, hybrid), and were based on non-parametric Kruskal-Wallis tests or parametric analysis of variance (ANOVA) tests for continuous variables and Fisher’s exact tests for categorical variables.

    • AIS, Abbreviated Injury Scale; GCS, Glasgow Coma Scale; HR, heart rate; ICU, intensive care unit; ISS, Injury Severity Score; LOS, length of stay; MTP, massive transfusion protocol; SBP, systolic blood pressure; TRISS, Trauma and Injury Severity Score.

PreviousNext
Back to top
Email

Thank you for your interest in spreading the word on TSACO.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention
(Your Name) has sent you a message from TSACO
(Your Name) thought you would like to see the TSACO web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention
Asanthi Ratnasekera, Odessa Pulido, Sandra Durgin, Sharon Nichols, Alicia Lozano, Danielle Sienko, Alexandra Hanlon, Niels D. Martin
Trauma Surg Acute Care Open Jun 2020, 5 (1) e000468; DOI: 10.1136/tsaco-2020-000468

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Cite This
  • APA
  • Chicago
  • Endnote
  • MLA
Loading
Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention
Asanthi Ratnasekera, Odessa Pulido, Sandra Durgin, Sharon Nichols, Alicia Lozano, Danielle Sienko, Alexandra Hanlon, Niels D. Martin
Trauma Surg Acute Care Open Jun 2020, 5 (1) e000468; DOI: 10.1136/tsaco-2020-000468
Download PDF

Share
Venous thromboembolism after penetrating femoral and popliteal artery injuries: an opportunity for increased prevention
Asanthi Ratnasekera, Odessa Pulido, Sandra Durgin, Sharon Nichols, Alicia Lozano, Danielle Sienko, Alexandra Hanlon, Niels D. Martin
Trauma Surgery & Acute Care Open Jun 2020, 5 (1) e000468; DOI: 10.1136/tsaco-2020-000468
Reddit logo Twitter logo Facebook logo Mendeley logo
Respond to this article
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Article
    • Abstract
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • When public health crises collide: 5 years of pediatric firearm injury prevention opportunities
  • Effects of hemodilution on coagulation function during prolonged hypotensive resuscitation in a porcine model of severe hemorrhagic shock
  • A porcine study of ultrasound-guided versus fluoroscopy-guided placement of endovascular balloons in the inferior vena cava (REBOVC) and the aorta (REBOA)
Show more Original research

Similar Articles

 
 

CONTENT

  • Latest content
  • Archive
  • eLetters
  • Sign up for email alerts
  • RSS

JOURNAL

  • About the journal
  • Editorial board
  • Thank you to our reviewers
  • The American Association for the Surgery of Trauma

AUTHORS

  • Information for authors
  • Submit a paper
  • Track your article
  • Open Access at BMJ

HELP

  • Contact us
  • Reprints
  • Permissions
  • Advertising
  • Feedback form

©Copyright 2023 The American Association for the Surgery of Trauma