Pulmonary embolism triggers

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Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], The APEX Trial Investigators; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

Venous thromboembolism (VTE) consists of deep vein thrombosis (DVT), pulmonary embolism (PE), or both. In these chapters on VTE, the word risk factors refers to those epidemiologic and genetic variables that expose someone to a higher risk of developing venous thrombosis. The word triggers refer to those factors in the patients immediate history or environment that may have lead to the occurrence of the venous thrombosis. The triggers of VTE include injury to a deep vein from surgery, a fracture, or other trauma, especially a paralytic spinal cord injury.[1] Another trigger for VTE is prolonged immobilization that causes stasis in the deep veins which may occur after surgery, prolonged bed-rest, or prolonged seating during travel.

Triggers

Shown below is a list of triggers of VTE.[1][2] The triggers are classified as strong, moderate, or weak depending on how strongly they predispose for a VTE.

Strong triggers Moderate triggers Weak triggers
Bone fracture (hip or leg)

Hip replacement surgery
❑ Knee replacement surgery
Major general surgery
Significant trauma
Spinal cord injury

❑ Athroscopic knee surgery

Central venous lines
Chemotherapy

❑ Bed rest for more than 3 days

❑ Prolonged car or air travel
Laparoscopic surgery
❑ Prepartum

References

  1. 1.0 1.1 Anderson FA, Spencer FA (2003). "Risk factors for venous thromboembolism". Circulation. 107 (23 Suppl 1): I9–16. doi:10.1161/01.CIR.0000078469.07362.E6. PMID 12814980. Unknown parameter |month= ignored (help)
  2. Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P; et al. (2008). "Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)". Eur Heart J. 29 (18): 2276–315. doi:10.1093/eurheartj/ehn310. PMID 18757870.

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