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In patients with trauma, several lines of evidence suggest that some clots in the pulmonary arterial circulation might represent in situ thrombosis, arising from inflammation-related hypercoagulability, rather than pulmonary embolism (PE) from deep venous thrombosis (DVT). To explore this issue further, researchers at 17 U.S. centers followed 7800 trauma patients (age range, 18–40) for 1 month to determine the incidence and risk factors for in situ pulmonary thrombosis (defined as a pulmonary clot on chest computed tomography angiography without concomitant lower-extremity DVT). Imaging decisions were left to treating surgeons; 10% of patients received no thromboprophylaxis.
The most common types of trauma were head or chest injury and long-…