Utility of the risk assessment profile for risk stratification of venous thrombotic events for trauma patients

被引:63
作者
Hegsted, Damian [1 ]
Gritsiouk, Yaroslav [1 ]
Schlesinger, Piroska [1 ]
Gardiner, Stuart [1 ]
Gubler, Kelly Dean [1 ]
机构
[1] Legacy Emanuel Med Ctr Trauma Serv, Portland, OR 97227 USA
关键词
Deep vein thrombosis; Pulmonary embolism; Risk Assessment Profile; Venous thromboembolism; MAJOR TRAUMA; THROMBOEMBOLISM; PROPHYLAXIS;
D O I
10.1016/j.amjsurg.2013.01.022
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Trauma patients are at risk for the development of venous thromboembolism (VTE). The purpose of this study was to validate the Risk Assessment Profile (RAP) as a tool for stratifying the risk of VTE. METHODS: RAP scores were calculated in a retrospective cohort analysis for all trauma patients aged 13 years or older admitted in 2003 and 2006 and hospitalized longer than 48 hours. Association of RAP with VTE, sensitivity, specificity, and receiver operating characteristic curve were included in the analysis. RESULTS: Of 2,281 patients, deep vein thrombosis (DVT) developed in 239 (10.5%) and pulmonary embolism (PE) developed in 34 (1.5%). In moderate-and high-risk patients, the RAP had a sensitivity of .82 and a specificity of .57. Identification of VTE for high-risk patients had a sensitivity .15 and a specificity of .97. The incidence of VTE increased significantly with risk level regardless of mechanism of injury. CONCLUSIONS: The RAP score is highly associated with VTE in trauma patients regardless of mechanism of injury and is a valid risk assessment tool. (C) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:517 / 520
页数:4
相关论文
共 8 条
[1]   Identification of Patient Venous Thromboembolism Risk Across the Continuum of Care [J].
Caprini, Joseph A. .
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS, 2011, 17 (06) :590-599
[2]   The risk assessment profile score identifies trauma patients at risk for deep vein thrombosis [J].
Gearhart, MM ;
Luchette, FK ;
Proctor, MC ;
Lutomski, DM ;
Witsken, C ;
James, L ;
Davis, K ;
Johannigman, JA ;
Hurst, JM ;
Frame, SB .
SURGERY, 2000, 128 (04) :631-637
[3]   A PROSPECTIVE-STUDY OF VENOUS THROMBOEMBOLISM AFTER MAJOR TRAUMA [J].
GEERTS, WH ;
CODE, KI ;
JAY, RM ;
CHEN, EL ;
SZALAI, JP .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (24) :1601-1606
[4]   A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma [J].
Geerts, WH ;
Jay, RM ;
Code, KI ;
Chen, EL ;
Szalai, JP ;
Saibil, EA ;
Hamilton, PA .
NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (10) :701-707
[5]   Posttrauma thromboembolism prophylaxis [J].
Greenfield, LJ ;
Proctor, MC ;
Rodriguez, JL ;
Luchette, FA ;
Cipolle, MD ;
Cho, J .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1997, 42 (01) :100-103
[6]   PREVENTION OF VENOUS THROMBOEMBOLISM IN TRAUMA PATIENTS [J].
KNUDSON, MM ;
LEWIS, FR ;
CLINTON, A ;
ATKINSON, K ;
MEGERMAN, J .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1994, 37 (03) :480-487
[7]   Designing and implementing effective venous thromboembolism prevention protocols: lessons from collaborative efforts [J].
Maynard, Greg ;
Stein, Jason .
JOURNAL OF THROMBOSIS AND THROMBOLYSIS, 2010, 29 (02) :159-166
[8]   Venous thromboembolism in the high-risk trauma patient: Do risks justify aggressive screening and prophylaxis? [J].
Spain, DA ;
Richardson, JD ;
Polk, HC ;
Bergamini, TM ;
Wilson, MA ;
Miller, FB .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1997, 42 (03) :463-467