A prospective study of thrombophilia in trauma patients with pulmonary embolism

作者：Gary Joshua L^*; Barber Robert C; Reinert Charles M; Starr Adam J

来源：Journal of Trauma and Acute Care Surgery, 2012, 72(1): 247-250.

• Thrombophilia
• pulmonary embolism
• trauma

BACKGROUND: Pulmonary embolism (PE) is a rare, but often fatal, complication of trauma. To date, there has been no study of the prevalence of thrombophilic abnormalities among trauma patients who sustain a PE. Our purpose was to determine whether heritable thrombophilia is associated with the development of PE in trauma patients. %26lt;br%26gt;METHODS: All patients admitted to the trauma service over a five-month period had residual blood from standard laboratory samples stored. Patients were then prospectively followed through their hospital. Greets%26apos; formula was used to estimate risk of thromboembolic disease. For every patient who developed a PE (n = 20), four controls with similar risk were randomly selected. DNA samples were genotyped. The genes screened included MTHFR, Factor II, Factor V, and Protein C. %26lt;br%26gt;RESULTS: DNA genotyping for Factor V and Protein C revealed only wild-type alleles in the cases. Genotyping of Factor II revealed mutations in 25% (10 of 40) of alleles in the cases and 17% (27 of 160) of alleles in the controls (p = 0.24). Mutation in alleles of the MTHFR1 gene occurred in 28% (11 of 40) of the cases and in 28% (40 of 150) of the controls (p = 0.92); genotyping in five of the controls (10 alleles) was indeterminate at the MTHFR1 alleles after testing. %26lt;br%26gt;CONCLUSIONS: No statistically significant differences were found in genetic abnormalities among trauma patients who developed PE and who did not; however, the sample size was small. Routine screening for thrombophilia in trauma patients is not recommended. (J Trauma. 2012;72: 247-250.

• 出版日期2012-1