scholarly journals Are venous thromboembolism risk assessment tools reliable in the stratification of microvascular risk following lower extremity reconstruction?

JPRAS Open ◽  
2021 ◽  
Author(s):  
L. Geoghegan ◽  
J. Super ◽  
M. Machin ◽  
M. Gimzewska ◽  
S. Onida ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Lower Extremity ◽  
Assessment Tools ◽  
Risk Assessment Tools ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

scholarly journals P19: THE RELIABILITY OF VENOUS THROMBOEMBOLISM RISK ASSESSMENT TOOLS FOLLOWING FREE FLAP RECONSTRUCTION OF THE LOWER EXTREMITIES

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
L Geoghegan ◽  
J Super ◽  
S Onida ◽  
S Hettiaratchy ◽  
A Davies
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Lower Extremity ◽  
Venous Thrombosis ◽  
Assessment Tools ◽  
Free Flap Reconstruction ◽  
Risk Assessment Tools ◽  
Patients At Risk ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

Abstract Introduction The incidence of flap failure in lower extremity reconstruction is significantly higher in the lower extremity compared head, neck and breast reconstruction. The commonest cause of flap failure is venous thrombosis. The aim of this study was to assess the reliability of VTE risk assessment tools in patients with open lower extremity fractures and to assess the ability of such tools to identify patients at risk of developing microvascular venous thrombosis following lower extremity free flap reconstruction. Method A single centre retrospective cohort study was conducted between August 2012-August 2019. All patients were risk assessed using the Department of Health (DoH), Modified Caprini and Padua VTE risk assessment tools. Result 58 patients were included, all were at high risk of DVT according to the DoH (mean score± SD, 3.7±0.93), Caprini (10.2±1.64) and Padua (5.4±0.86) risk assessment tools. All patients received thromboprophylaxis, the incidence of clinical deep venous thrombosis was 0%. Intraclass correlation coefficient demonstrated moderate agreement between the Caprini and DoH (0.73, 95% CI 0.54-0.84, p<0.001), the Caprini and Padua (0.52, 95% CI 0.19-0.72, p<0.001) and the DoH and Padua (0.74, 95% CI 0.57-0.85, p<0.001). Microvascular venous thrombosis occurred in 6 patients, resulting in 2 amputations. There were no significant differences in scores between those with and without venous complications. Conclusion Current VTE risk assessment tools do not identify patients at risk of developing venous complications following lower extremity reconstruction. Further prospective studies are required to optimise risk prediction models and thromboprophylaxis use in this cohort. Take-home message Current VTE risk assessment tools do not identify patients at risk of developing microvascular venous thrombosis following lower limb reconstruction.

scholarly journals Advances in research on personalized venous thromboembolism risk assessment tools

2016 ◽  
Vol 3 (3) ◽  
pp. 113-116 ◽  
Author(s):  
Chun-Li Wu ◽  
Mei Lin ◽  
Ying Bao ◽  
Xiang Wang
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Tools ◽  
Risk Assessment Tools

The Need for a Lower Extremity Risk Assessment Model

2009 ◽  
Vol 53 (14) ◽  
pp. 887-891
Author(s):  
Christopher R. Reid ◽  
Pamela McCauley-Bush ◽  
Waldemar Karwowski ◽  
Dianne L. McMullin
Keyword(s):  
Risk Assessment ◽  
Lower Extremity ◽  
Assessment Tools ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Initial Model ◽  
Preliminary Step ◽  
Work Related ◽  
Risk Assessment Tools ◽  
Work Related Musculoskeletal Disorders

Current ergonomic risk assessment tools do not assess possible occupational (extrinsic) and personal (intrinsic) risk factors for the lower extremity regions of employees. This document proposes that it is possible to develop a lower extremity risk assessment (LERA) model for quantifying such risks. A literature review was conducted for work-related musculoskeletal disorders of the lower extremity that affect the nervous, muscular, vascular, and skeletal systems. This initial model of LERA was developed using epidemiological literature and subject matter expert opinion specifically for the knee joint and is considered a preliminary step towards quantifying the etiology of cumulative occupational knee disorders.

scholarly journals Venous thromboembolism following initiation of atypical antipsychotics in two geriatric patients

2017 ◽  
Vol 7 (2) ◽  
pp. 51-55 ◽  
Author(s):  
Thomas J. Maestri ◽  
Jessica Koenig ◽  
Christine Masuda ◽  
Tawny L. Smith ◽  
Erica C. Garcia-Pittman
Keyword(s):  
Risk Assessment ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Atypical Antipsychotics ◽  
Assessment Tools ◽  
Minimal Risk ◽  
Newly Diagnosed ◽  
Antipsychotic Therapy ◽  
Bipolar I Disorder ◽  
Risk Assessment Tools

Abstract Background: Although not formally highlighted as a risk factor in current practice guidelines, several observational studies have reported a possible association between antipsychotic use and development of venous thromboembolism (VTE). However, it is unclear to what extent the risk is elevated. Case Report: Described are 2 cases of VTE following recent initiation of second-generation antipsychotics in elderly patients. Ms A was a 65-year-old woman with newly diagnosed bipolar I disorder who was hospitalized for acute mania and psychosis. She was treated with risperidone along with traditional mood stabilizers and developed a pulmonary embolism shortly after treatment initiation. Ms B was a 77-year-old woman with newly diagnosed bipolar I disorder who was hospitalized for depression and psychosis. She was treated with quetiapine and electroconvulsive therapy and developed a pulmonary embolism and deep vein thrombosis within 2 months of starting treatment. Risk assessment tools were not able to definitively predict the VTEs that developed in our patients. Conclusion: The association between antipsychotic medication and VTE has shown the highest risk with atypical antipsychotics, high dosages, and initiation within the past 3 months. Risk assessment tools may assist in assessing the risk of VTE in patients on antipsychotic therapy, although patients who are deemed by these tools to have minimal risk can still develop a VTE. Discussing VTE risk with patients when considering antipsychotic usage may help clinicians and patients safely determine the most appropriate treatment for their psychiatric illnesses while mitigating potential adverse effects.

scholarly journals Venous thromboembolism risk assessment tools: Do we need a consensus?

2019 ◽  
Vol 34 (9) ◽  
pp. 579-581
Author(s):  
Matthew Machin ◽  
Safa Salim ◽  
Sarah Onida ◽  
Alun H Davies
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Tools ◽  
Risk Assessment Tools
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