Incidence and Risk Factors Associated with Venous Thromboembolism in Thai Trauma Patients

Background: Venous thromboembolism (VTE) is a major problem in trauma patients, especially in Western countries. The incidence of VTE in Asian trauma patients is lower. Hence, chemoprophylaxis such as anticoagulation is not routinely used at the authors’ institution. Objective: To identify the incidence and risk factors of VTE in Thai trauma patients not on chemoprophylaxis. Materials and Methods: Trauma patients admitted between September 2021, and December 2022 were screened for lower extremity deep vein thrombosis (DVT) using Doppler ultrasonography (DUS). Stepwise linear regression analysis was performed to identify factors associated with the development of VTE. Results: Five hundred seventy-nine patients were included, of whom 396 were male (68%), and 183 were female (32%), with the mean age of 51.5 years. Nine patients had VTE, thus a VTE rate of 1.6%. Three had isolated DVT, five had isolated pulmonary embolism (PE), and one had combined DVT and PE. The risk factors for VTE were female (p=0.009, OR 10.1, 95% CI 1.8 to 56.9), spinal cord injury (p=0.015, OR 11.9, 95% CI 1.6 to 87.6), and length of stay (LOS) more than seven days (p=0.039, OR 7.5, 95% CI 1.1 to 51.1). One patient in the VTE group died of massive PE, thus the mortality rate in the VTE group was 11%. Conclusion: The incidence of VTE in Thai trauma patients was 1.6%. Risk factors for VTE included female gender, spinal cord injury, and prolonged hospitalization. Further studies are needed to identify a subgroup of patients who would benefit from chemoprophylaxis.