During five years study period, we studied 206,708 TBI cases, of which 1324 developed PE (0.65%) and 3584 developed DVT (1.8%). The cohort was composed mostly of white (71.5%), and males (60%) with a mean age of 64.8 y/o. Most types of TBIs were subdural hematoma (49.3%). The patients who developed PE were younger (61.1 vs. 64.9, p<0.001), male (66.9%, p<0.001), had longer hospital stays (18.4 vs 6.9 d, p<0.001), and had significantly higher mortality (13,7% vs. 8.1%, p<0.001).

In Multivariate analysis, having DVT (OR.9.85, 95% CI [5.5-17.6], p<0.001), COPD (OR, 1.33, 95% CI[ 1.08-1.64], p=0.009) and Renal disease (OR 1.3 , 95%CI[ 1.3-1.5], p<0.001) and black race (OR1.27, 95%CI[ 1.07-1.5], p=0.006) had the highest impact on developing PE. Of the different types of TBI, Epidural hemorrhage had the most effect on developing PE (OR. 1.43, 95%CI [ 1.01-2.02],p=0.04). 

Our data shows the incidence of PE and DVT in TBI is low; however, it's lethal with a high LOS. The incidence of PE is higher in Blacks and in those with DVT, COPD, and Renal failure. Among different types of TBI, Epidural hematoma has the highest association with the development of PE.