The incidence of thromboembolism formation following the use of recombinant factor VIIa in patients suffering blunt force compared to penetrating trauma: a systematic review protocol

Review question/objective This review aims to identify the incidence of thromboembolism formation in patients suffering traumatic injuries after receiving recombinant factor VIIa. To achieve this objective, the following question will be addressed. In both civilian and combat trauma patients 15 years or older that have received intravenous recombinant factor VIIa, is there a difference in the incidence of thromboembolism formation between injuries sustained from blunt force trauma compared to injuries sustained from penetrating trauma? Inclusion criteria Types of participants This review will consider studies of participants who are: 15 years and older suffering blunt force trauma and penetrating trauma injuries, and civilian and combat trauma injuries. Patients suffering burn injuries, a combination of blunt force and penetrating trauma and those patients with a combination of blunt force trauma and penetrating trauma and those on pharmacological anticoagulation will be excluded from this review. Types of intervention(s)/phenomena of interest The incidence of thromboembolism formation associated with rFVIIa administration including: control (non-recombinant factor VIIa and recombinant factor VIIa in blunt force trauma populations control (non-recombinant factor VIIa  and recombinant factor VIIa in penetrating trauma populations in both control and recombinant factor VIIa, usual care will be administered to include packed red blood cells, fresh frozen plasma, platelets and crystalloid solutions. Types of outcomes Criteria used to determine a diagnosis of thromboembolism may differ based on varying guidelines. Criteria used in each study reviewed will be considered in an assessment of heterogeneity between studies. Diagnosis of thromboembolism formation will be confirmed by the following: Deep venous thrombosis  high-sensitivity D-dimer assay ultrasound. Pulmonary embolism  ventilation-perfusion scan computerized tomography  pulmonary angiography.