Venous Thromboembolism Risk Assessment and Prophylaxis in Trauma Patients

TL;DR

This study shows that using risk assessment scales can help prevent dangerous blood clots in trauma patients, improving outcomes and reducing healthcare costs.

Contribution

The study evaluates the Greenfield risk assessment profile score in trauma patients and its association with VTE and bleeding complications.

Findings

46.6% of trauma patients were categorized as high-risk for VTE using the Greenfield score.

Proper use of pharmacological prophylaxis must balance VTE prevention with bleeding risks.

All VTE cases were high-risk according to the Greenfield score, with 3% of the group affected.

Abstract

Public health relevance—How does this work relate to a public health issue?
Venous thromboembolism (VTE) constitutes a significant cause of preventable morbidity and mortality among trauma patients globally.Standardized risk assessment scales are essential tools for identifying high-risk trauma patients who require VTE prophylaxis.

Venous thromboembolism (VTE) constitutes a significant cause of preventable morbidity and mortality among trauma patients globally.

Standardized risk assessment scales are essential tools for identifying high-risk trauma patients who require VTE prophylaxis.

Public health significance—Why is this work of significance to public health?
This study demonstrates that using specific risk assessment scales can reduce the incidence of deep vein thrombosis and pulmonary embolism in trauma care settings.Preventing hospital-acquired VTE in trauma patients significantly reduces healthcare expenses and long-term complications.

This study demonstrates that using specific risk assessment scales can reduce the incidence of deep vein thrombosis and pulmonary embolism in trauma care settings.

Preventing hospital-acquired VTE in trauma patients significantly reduces healthcare expenses and long-term complications.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Practitioners are advised to consistently utilize validated risk assessment scales to inform clinical decision-making concerning VTE prophylaxis within trauma departments.Hospitals and policymakers should require VTE risk stratification protocols as a standard quality indicator for trauma care.

Practitioners are advised to consistently utilize validated risk assessment scales to inform clinical decision-making concerning VTE prophylaxis within trauma departments.

Hospitals and policymakers should require VTE risk stratification protocols as a standard quality indicator for trauma care.

Background: Venous thromboembolism (VTE) is associated with high morbidity and mortality. The activation of multiple pathways of venous thrombosis occurs after an injury. A prophylaxis protocol is necessary to prevent early and late venous thrombotic complications. Methods: This study aimed to evaluate the outcomes of venous thromboembolism using the Greenfield risk assessment profile score and its association with bleeding complications. This was a retrospective cohort study conducted on trauma cases who were aged 15 years or older. The study was conducted from January 2020 through December 2022. Patients who were admitted to hospital for less than 24 h or those who died during resuscitation or treatment in an emergency room were excluded from this study. Results: We enrolled 580 cases. Among them, 46.6% were categorized as high-risk for developing venous thromboembolism, and 30.4% of these high-risk patients received pharmaco-mechanical thromboprophylaxis. All VTE cases were high risk according to the Greenfield risk assessment profile, accounting for 3% of the entire group and 1.4% of all enrolled cases. All major bleeding complications occurred with a previously diagnosed large subdural hematoma. Conclusions: Assessing VTE risk was crucial for optimal management of prophylaxis. Proper use of pharmacological prophylaxis had to be balanced against the risk of bleeding complications.

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