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Screening for major deep vein thrombosis in seriously injured patients: A prospective study

  • Original Article
  • Published:
Annals of Vascular Surgery

Abstract

The purpose of the study is to determine the prevalence of acute deep venous thrombosis (DVT) in severely injured trauma patients, to investigate the cost effectiveness of a noninvasive surveillance program, and to assess the merit of current methods of prophylaxis against DVT. One hundred and forty-eight patients (295 limbs) with a mean age of 36.5 years, mean trauma score of 13.3, mean injury severity score of 22.4 with predominantly blunt injuries (88.5%), were part of the study. The mean length of stay was 17.6 days. Venous duplex scans (VDS) were performed on inpatients on days 2-5, day 11, and day 30 following admission. Sequential compression device and/or subcutaneous heparin was used in 99% of patients with compliance being monitored by trauma nurse clinicians. A total of 272 VDS were performed with total charges of $111,520. DVT was found by VDS or venography in eight limbs (2.7%) of six patients (4%), four of the limbs being symptomatic. Two additional patients had pulmonary embolism, both with normal VDS. Routine serial VDS in severely injured patients who undergo aggressive prophylaxis against DVT is not cost effective and therefore not justified. (Ann Vasc Surg 1997; 11:626-629.)

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References

  1. Shackford SR, Moser KM. Deep venous thrombosis and pulmonary embolism in trauma patients. J Int Care Med 1988; 3:87–98.

    Article  Google Scholar 

  2. Knudson MM, Collins JA, Goodman SB, McCrory DW.Thromboembolism following multiple trauma. J Trauma 1992;32:2–11.

    PubMed  CAS  Google Scholar 

  3. Dennis JW, Menawat S, Thron JV, et al. Efficacy of deep venous thrombosis prophylaxis in trauma patients and identification of high risk groups. J Trauma 1993;35:132–139.

    Article  PubMed  CAS  Google Scholar 

  4. Burns GA, Cohn SM, Frumento RJ, Degutis LC, Hammers L. Prospective ultrasound evaluation of venous thrombosis in high risk trauma patients. J Trauma 1993;35:405–408.

    Article  PubMed  CAS  Google Scholar 

  5. Sevitt S, Gallagher N. Venous thrombosis and pulmonary embolism: A clinic-pathologic study in injured and burned patients. Br J Surg 1960;48:475–489.

    Article  Google Scholar 

  6. Freeark RJ, Boswick J, Fardin R. Posttraumatic venous thrombosis. Arch Surg 1967;95:567–573.

    PubMed  CAS  Google Scholar 

  7. Green D, Lee MY, Ito VY, et al. Fixed vs adjusted dose heparin in the prophylaxis of thromboembolism in spinal cord injury. JAMA 1988;260:1255–1258.

    Article  PubMed  CAS  Google Scholar 

  8. Kudsk KA, Fabian TC, Baum S, Gold RE, Mangiante E, Voeller G. Silent DVT in immobilized multiple trauma patients. Am J Surg 1989;158:515–519.

    Article  PubMed  CAS  Google Scholar 

  9. Ruiz AJ, Hill SL, Berry RE. Heparin, deep venous thrombosis, and trauma patients. Am J Surg 1991;162:159–162.

    Article  PubMed  CAS  Google Scholar 

  10. Comerota AJ, Katz ML, Greenwald LL, et al. Venous Duplex Imaging: Should it replace hemodynamic tests for deep venous thrombosis. J Vasc Surg 1989;11:53–61.

    Article  Google Scholar 

  11. Meyer CS, Blebea J, Davis K, Fowl RJ, Kempczinski RF. Surveillance venous scans for deep venous thrombosis in multiple trauma patients. Ann Vasc Surg 1995;9:109–114.

    Article  PubMed  CAS  Google Scholar 

  12. Shackford SR, Davis JW, Hollingsworth-Fridleund P, et al. Venous thromboembolism in patients with major trauma. Am J Surg 1990;159:365–369.

    Article  PubMed  CAS  Google Scholar 

  13. Tarnay TJ, Rohr PR, Davidson AG, et al. Pneumatic calf compression, fibrinolysis and the prevention of deep venous thrombosis. Surgery 1980;88:489–494.

    PubMed  CAS  Google Scholar 

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Satiani, B., Falcone, R., Shook, L. et al. Screening for major deep vein thrombosis in seriously injured patients: A prospective study. Annals of Vascular Surgery 11, 626–629 (1997). https://doi.org/10.1007/s100169900101

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