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Introduction The optimal time to initiate venous thromboembolism (VTE) chemoprophylaxis in blunt solid organ injury (BSOI) patients is debated. We hypothesize that 1) BSOI patients are hypercoagulable within 12 h of injury and 2) hypercoagulability dominates in patients who develop clot complications (CC). Material and methods This is a prospective study of BSOI patients admitted to two Level-1 Trauma Centers’ trauma intensive care units (ICU). Serial kaolin thrombelastography (TEG) and tissue plasminogen activator (tPA)-challenge TEGs were performed. CC included VTE and cerebrovascular accidents. Results On ICU admission, all patients (n = 95) were hypercoagulable, 58% were in fibrinolysis shutdown, and 50% of patients were tPA-resistant. Twelve patients (13%) developed CC. Compared to those without CC, they demonstrated decreased fibrinolysis at 12 h and higher clot strength at 48 h Conclusions BSOI patients are universally hypercoagulable upon ICU admission. VTE chemoprophylaxis should be started immediately in BSOI patients with hypercoagulability on TEG.

We aimed to describe elderly engagement in recreational activities, their injury patterns, preinjury risks and outcomes.A 16-year retrospective trauma registry review. All trauma patients ≥65 years admitted after injury sustained during sport were evaluated, and compared to a non-sport cohort of elderly trauma patients.During the study period, 9697 admissions age ≥65 were identified. 526 (5%) were sport-related. Compared to the non-sport group, the sport cohort was younger, had fewer medical comorbidities, and was more severely injured. The common sport mechanisms were skiing, offroad vehicle use and bicycling, and common sport injuries involved lower extremity, chest, and head. Sport patients were more often discharged home than non-sport patients (73% vs 36%, p 0.001). There was no difference in ICU or hospital LOS between groups. The hospital mortality rate was 3% in sport and 5% in non-sport patients (p = 0.06).Over time, the number of elderly sport-related trauma patients increased. Our data suggest that being active may improve outcomes after trauma in older adults.