Related Experiment Video
Updated: Mar 31, 2026
06:45
Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
16.9K
The "high-risk" deep venous thrombosis screening protocol for trauma patients: Is it practical?
The Journal of Trauma and Acute Care Surgery
|October 22, 2015
Summary
Implementing aggressive lower extremity deep venous thrombosis (DVT) screening in trauma patients is impractical and costly. A predictive model showed poor sensitivity and positive predictive value, suggesting high-risk DVT screening is not cost-effective.
Area of Science:
- Trauma surgery
- Vascular surgery
- Diagnostic imaging
Background:
- Many centers use aggressive lower extremity deep venous thrombosis (DVT) screening with ultrasound (LUS) for high-risk trauma patients.
- This study hypothesized that such screening protocols are impractical and costly.
Purpose of the Study:
- To evaluate the practicality and cost-effectiveness of a high-risk screening protocol for DVT in trauma patients.
- To assess the performance of a predictive model for DVT in this population.
Main Methods:
- Retrospective analysis of 6,656 trauma patients admitted between 2009-2013.
- Multivariate analyses to identify DVT risk factors.
- Application of a predictive DVT model to assess performance and resource requirements.
Main Results:
- 35.3% of patients underwent LUS; 6.2% developed DVT.
- Factors associated with DVT included ICU length of stay, blood transfusions, spinal cord injury, and pelvic fracture.
- A predictive model had a c-statistic of 0.87 but required screening 26% of patients, costing nearly $600,000, detecting only 53% of DVTs.
Conclusions:
- A predictive model for DVT in trauma patients showed poor sensitivity and positive predictive value.
- Implementing high-risk DVT screening protocols is resource-intensive and may not be practical or cost-effective for trauma patients.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
466
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
466
01:30Venous Thrombosis IV: Nursing Management
382
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
382
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
438
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
438
01:30Venous Thrombosis I: Introduction
695
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
695
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
661
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
661
01:27Pulmonary Embolism III: Nursing Management
668
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
668