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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Venous thromboembolism in trauma patients
Om P Sharma1, Michael F Oswanski, Rusin J Joseph
1Department of Trauma Services, Toledo Hospital and Toledo Children's Hospital, Toledo, Ohio 43606, USA. om.sharma.md@promedica.org
The American Surgeon
|December 21, 2007
Summary
Serial venous duplex scans in trauma patients identified deep vein thrombosis (DVT) in 6.1% of cases. High-risk patients (≥5 risk factors) showed a significantly higher DVT incidence, with specific injuries like spinal cord injury and pelvic fractures being key indicators.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Diagnostic Imaging
Background:
- Venous thromboembolism (VTE), including deep vein thrombosis (DVT), is a significant concern in trauma patients.
- Identifying patients at high risk for DVT is crucial for timely intervention and prevention of complications.
- Risk stratification models and diagnostic tools like venous duplex scans (VDS) are essential in managing VTE risk.
Purpose of the Study:
- To evaluate the incidence of DVT in trauma patients with at least one risk factor (RF) for VTE.
- To identify specific risk factors and injury patterns associated with a higher incidence of DVT.
- To assess the utility of serial VDS in detecting DVT within this patient population.
Main Methods:
- A prospective study involving 507 trauma patients with at least one VTE risk factor.
- Serial venous duplex scans (VDS) were performed throughout the study period.
- Patients were categorized based on the number of risk factors and VTE scores; specific injuries were analyzed for their association with DVT.
Main Results:
- Deep vein thrombosis (DVT) was detected in 6.1% of the 507 trauma patients.
- A statistically significant difference in DVT incidence was observed between high-risk (≥5 RFs) and low-risk (<5 RFs) groups (7.2% vs. 3%).
- Previous VTE, spinal cord injury, pelvic fractures, and severe head injury (AIS > 2) were identified as significant independent risk factors for DVT.
Conclusions:
- Serial VDS is effective in diagnosing DVT in trauma patients, with the first two scans identifying 77% of DVTs.
- Patients with higher VTE scores, increased length of stay, and more VDS examinations had a higher likelihood of DVT.
- Specific injuries and a higher number of risk factors significantly increase DVT risk, necessitating targeted screening and prophylaxis.
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