Identifying Patients at Risk for Venous Thromboembolic Events After Isolated Upper Extremity Trauma: A Predictive...

Area of Science:

• Orthopedic Surgery
• Vascular Surgery
• Trauma Surgery

Background:

• Limited data exist on venous thromboembolism (VTE) risk following upper extremity orthopedic trauma.
• Previous research has primarily focused on risk factors for VTE in lower extremity trauma patients.

Purpose of the Study:

• To identify risk factors for VTE in patients with upper extremity orthopedic trauma.
• To develop and validate a predictive scale for VTE risk after upper extremity trauma.

Main Methods:

• Analysis of 269,137 upper extremity trauma cases from a 4-state database (2006-2014).
• Development of the Thromboembolic Risk after Upper Extremity Trauma (TRUE-T) scale using logistic regression in a derivation cohort.
• Validation of the TRUE-T scale using linear regression in a separate validation cohort.

Main Results:

• VTE occurred in 2.61% (derivation) and 2.72% (validation) of patients within 90 days of discharge.
• Identified risk factors include age >40, Medicare, anemia, COPD, coagulopathy, heart failure, malignancy, obesity, renal failure, and specific injuries/treatments.
• The TRUE-T scale demonstrated strong predictive fit (R=0.88) in the validation cohort.

Conclusions:

• The TRUE-T scale effectively identifies patients at increased risk for VTE after upper extremity orthopedic trauma.
• The scale incorporates patient factors, concomitant injuries, and fracture treatment modalities.
• Utilizing the TRUE-T scale can aid in targeted VTE prevention strategies for at-risk individuals.