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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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The prevalence of chronic deep venous thrombosis in trauma: Implications for hospitals and patients

Kathleen A Cannon1, Jayraan Badiee, James D Wallace

  • 1From the Trauma Service, Scripps Mercy Hospital, San Diego, California (K.A.C., JB., J.D.W., J.B.B., M.J.S., V.B., C.B.S., S.R.S.).

The Journal of Trauma and Acute Care Surgery
|September 2, 2017
PubMed

Insights

Chronic deep venous thrombosis (DVT) affects nearly 30% of trauma patients with DVT. Identifying chronic DVT in trauma patients is crucial for appropriate prophylaxis and management to prevent complications.

Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Diagnostic Imaging

Background:

  • Deep venous thrombosis (DVT) is a significant complication in trauma patients, with hospitals facing financial penalties for high rates.
  • Distinguishing chronic DVT (pre-admission) from acute DVT is important as penalties do not apply to chronic cases.
  • Lower-extremity duplex ultrasound (LEDUS) can differentiate between acute and chronic DVT based on thrombus characteristics.

Purpose of the Study:

  • To determine the prevalence of chronic deep venous thrombosis (DVT) in hospitalized trauma patients.
  • To analyze the characteristics and outcomes of trauma patients with chronic DVT.
  • To inform clinical management strategies for DVT in trauma populations.

Main Methods:

  • Retrospective review of trauma patients admitted to a Level I trauma center from July 2006 to October 2016.
  • Analysis of initial lower-extremity duplex ultrasound (LEDUS) findings to classify DVT chronicity (acute, chronic, indeterminate).
  • Collection and comparison of demographic, medical history, and injury characteristics between acute and chronic DVT groups.

Main Results:

  • Chronic DVT was present in 29.9% of trauma patients with DVT on initial LEDUS.
  • Patients with chronic DVT were older and had less severe injuries compared to those with acute DVT.
  • Progression or new DVT formation occurred in 23% of chronic DVT patients who underwent follow-up LEDUS.

Conclusions:

  • Chronic DVT is prevalent in nearly 30% of trauma patients identified with DVT via initial screening LEDUS.
  • Trauma patients with chronic DVT require pharmacologic and mechanical prophylaxis due to risks of progression and new DVT formation.
  • Counseling on recurrence risk and chronic venous insufficiency is recommended for patients with chronic DVT.
Abstract

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