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Traditional teaching is that pulmonary embolism typically occurs at least 5 days after trauma and that patients with pelvic or lower extremity fracture, severe head injury, or spinal cord injury are at greatest risk. To confirm or refute these tenets, researchers reviewed trauma registry data from a single level I trauma center for all patients diagnosed with pulmonary embolism from 1999 through 2004.
Of 94 trauma patients with pulmonary embolism, 92.6% had one or more of tachypnea, tachycardia, or hypoxia. The average time to diagnosis was 11.8 days, but 15% of emboli were diagnosed within 2 days and 37% within 4 days. Areas of injury included the thorax (37%), lower leg or femur (38%), pelvis (22%), and spinal cord (30%, with neurologic de…