The risk assessment profile score identifies trauma patients at risk for deep vein thrombosis

Surgery ◽  
2000 ◽  
Vol 128 (4) ◽  
pp. 631-640 ◽  
Author(s):  
Michelle M. Gearhart ◽  
Fred A. Luchette ◽  
Mary C. Proctor ◽  
Dave M. Lutomski ◽  
Christine Witsken ◽  
...  
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Deep Vein Thrombosis ◽  
Trauma Patients ◽  
Vein Thrombosis ◽  
Profile Score ◽  
Patients At Risk ◽  
Deep Vein

Lethal Trauma Pulmonary Embolism is a Black Swan Event in Patients at Risk for Deep Vein Thrombosis: An Evidence-Based Review

2017 ◽  
Vol 83 (4) ◽  
pp. 403-413 ◽  
Author(s):  
C. Michael Dunham ◽  
Gregory S. Huang
Keyword(s):  
At Risk ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Confidence Interval ◽  
Hospital Stay ◽  
Trauma Patients ◽  
Black Swan ◽  
Vein Thrombosis ◽  
Patients At Risk ◽  
Deep Vein

We delineated the incidence of trauma patient pulmonary embolism (PE) and risk conditions by performing a systematic literature review of those at risk for deep vein thrombosis (DVT). The PE proportion was 1.4 per cent (95% confidence interval = 1.2–1.6) in at-risk patients. Of 10 conditions, PE was only associated with increased age (P < 0.01) or leg injury (P < 0.01; risk ratio = 1.6). As lower extremity DVT (LEDVT) proportions increased, mortality proportions (P = 0.02) and hospital stay (P = 0.0002) increased, but PE proportions did not (P = 0.13). LEDVT was lower with chemoprophylaxis (CP) (4.9%) than without CP (19.1%; P < 0.01). PEwas lower withCP (1.0%) than without CP (2.2%; P = 0.0004). Mortality was lower with CP (6.6%) than without CP (11.6%; P = 0.002). PE was similar with (1.2%) and without (1.9%; P = 0.19) mechanical prophylaxis (MP). LEDVT was lower with MP (8.5%) than without MP (12.2%; P = 0.0005). PE proportions were similar with (1.3%) and without (1.5%; P = 0.24) LEDVTsurveillance. Mortality was higher with LEDVTsurveillance (7.9%) than without (4.8%; P < 0.01). A PE mortality of 19.7 per cent (95% confidence interval = 18–22) 3 a 1.4 per cent PE proportion yielded a 0.28 per cent lethal PE proportion. As PE proportions increased, mortality (P = 0.52) and hospital stay (P = 0.13) did not. Of 176 patients with PE, 76 per cent had no LEDVT. In trauma patients at risk for DVT, PE is infrequent, has a minimal impact on outcomes, and death is a black swan event. LEDVTsurveillance did not improve outcomes. Because PE was not associated with LEDVT and most patients with PE had no LEDVT, preventing, diagnosing, and treating LEDVT may be ineffective PE prophylaxis.

scholarly journals EFFECTIVENESS OF RANGE OF MOTION (ROM) EXERCISES ON KNOWLEDGE AND PRACTICE OF CARE GIVERS OF PATIENTS AT RISK OF DEEP VEIN THROMBOSIS (DVT) ADMITTED IN A SELECTED TERTIARY HOSPITAL, DEHRADUN, UTTARAKHAND

2020 ◽  
pp. 79-80
Author(s):  
Neha Sharma ◽  
Harleen Kaur ◽  
Dipti. Y. Sorte ◽  
Sanchita Pugazhendi
Keyword(s):  
At Risk ◽  
Deep Vein Thrombosis ◽  
Range Of Motion ◽  
Pretest Score ◽  
Vein Thrombosis ◽  
Care Givers ◽  
Patients At Risk ◽  
Knowledge And Practice ◽  
Patient At Risk ◽  
Deep Vein

DVT is an ordinary issue after surgery, long bed rest. Mostly it occurs in a hospitalized patient who is immobile and suffering from long term illness. ROM is a term that determines the quantity of movement of each joint. The easiest intervention to maintain or enhance joint movement and also the blood flow in patients. Objective: To evaluate the effectiveness of range of motion exercises on knowledge and practice of care givers of patients at risk of Deep Vein Thrombosis. Methodology: A Time Series Research Design was used to evaluate the effectiveness of range of motion exercises on knowledge and practice of care givers of patients at risk of Deep Vein Thrombosis. Purposive sampling technique was used to select 94 care givers of patient at risk of Deep Vein Thrombosis. Data was collected by Interview method with the help of structured knowledge questionnaire and structured practice checklist. Results: Mean pretest score was computed 11.01±1.8 and mean posttest score was computed 23.94±0.37. So, the mean posttest knowledge score of caregivers of patient at risk of Deep Vein Thrombosis and Range of motion exercises was higher than that of their mean pretest knowledge scores. Repeated Measure ANOVA was performed to find the difference in the practice score between three observations. Mean posttest practice score was higher than that of their mean pretest score. Mean pretest practice score was 7.59±1.10 and mean posttest practice scores were 9.67+0.51, 10±0. Conclusion: Present research Study concluded that intervention on range of motion exercises was effective to improve the knowledge and practices of care givers of patient at risk of Deep Vein Thrombosis.

Physiotherapeutic mechanisms for prevention of deep vein thrombosis in patients at risk of haemorrhage

2004 ◽  
Author(s):  
Jefferson Rosa Cardoso ◽  
Álvaro N Atallah ◽  
Maria Aparecida Campos ◽  
Edson Lopes Lavado
Keyword(s):  
At Risk ◽  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Patients At Risk ◽  
Deep Vein

scholarly journals A rare case of deep vein thrombosis in upper extremity: a case report

2020 ◽  
Vol 8 (11) ◽  
pp. 4155
Author(s):  
Mohammed Adnan Sheerazi ◽  
Furqan Mohd. Akram Khan
Keyword(s):  
At Risk ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Upper Extremity ◽  
Upper Limb ◽  
Rare Case ◽  
Lower Extremities ◽  
Vein Thrombosis ◽  
Patients At Risk ◽  
Deep Vein

The incidence of deep vein thrombosis (DVT) in upper limb is less common as compared to lower extremities. There were no institutional screening protocols for patients at risk of DVT in upper limb. Hence this case report was presented to describe the features of upper limb DVT.

scholarly journals A preliminary study of intensivist-performed DVT ultrasound screening in trauma ICU patients (APSIT Study)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lloyd Roberts ◽  
Tom Rozen ◽  
Deirdre Murphy ◽  
Adam Lawler ◽  
Mark Fitzgerald ◽  
...  
Keyword(s):  
Intensive Care ◽  
Deep Vein Thrombosis ◽  
High Risk ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Major Trauma ◽  
Intraclass Correlation ◽  
Trauma Patients ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract Background Multiple screening Duplex ultrasound scans (DUS) are performed in trauma patients at high risk of deep vein thrombosis (DVT) in the intensive care unit (ICU). Intensive care physician performed compression ultrasound (IP-CUS) has shown promise as a diagnostic test for DVT in a non-trauma setting. Whether IP-CUS can be used as a screening test in trauma patients is unknown. Our study aimed to assess the agreement between IP-CUS and vascular sonographer performed DUS for proximal lower extremity deep vein thrombosis (PLEDVT) screening in high-risk trauma patients in ICU. Methods A prospective observational study was conducted at the ICU of Alfred Hospital, a major trauma center in Melbourne, Australia, between Feb and Nov 2015. All adult major trauma patients admitted with high risk for DVT were eligible for inclusion. IP-CUS was performed immediately before or after DUS for PLEDVT screening. The paired studies were repeated twice weekly until the DVT diagnosis, death or ICU discharge. Written informed consent from the patient, or person responsible, or procedural authorisation, was obtained. The individuals performing the scans were blinded to the others’ results. The agreement analysis was performed using Cohen’s Kappa statistics and intraclass correlation coefficient for repeated binary measurements. Results During the study period, 117 patients had 193 pairs of scans, and 45 (39%) patients had more than one pair of scans. The median age (IQR) was 47 (28–68) years with 77% males, mean (SD) injury severity score 27.5 (9.53), and a median (IQR) ICU length of stay 7 (3.2–11.6) days. There were 16 cases (13.6%) of PLEDVT with an incidence rate of 2.6 (1.6–4.2) cases per 100 patient-days in ICU. The overall agreement was 96.7% (95% CI 94.15–99.33). The Cohen’s Kappa between the IP-CUS and DUS was 0.77 (95% CI 0.59–0.95), and the intraclass correlation coefficient for repeated binary measures was 0.75 (95% CI 0.67–0.81). Conclusions There is a substantial agreement between IP-CUS and DUS for PLEDVT screening in trauma patients in ICU with high risk for DVT. Large multicentre studies are needed to confirm this finding.

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