Journal article
The Utility of Lower Extremity Screening Duplex for The Detection of Deep Vein Thrombosis in Trauma
The Journal of surgical research, v 269, pp 151-157
01 Jan 2022
PMID: 34563841
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Trauma patients are high-risk for venous thromboembolism (VTE). Lower extremity screening duplex ultrasonography (LESDUS) is controversial and not standardized for early VTE diagnosis. By implementing risk stratification and selective screening, we aim to optimize resource utilization. Materials and methods: A retrospective review were conducted at a Level-1 Trauma Center, January 2015-October 2019. LESDUS was performed within 72-h of presentation, then weekly. Demographics, VTE data, and outcomes were collected from the trauma registry. Risk assessment profile (RAP) score was calculated based on collected data. Results: Of 5,645 patients included, 2,813 (49.8%) were screened for lower extremity deep vein thrombosis (LEDVT). Of 187 patients with LEDVT, 154 were diagnosed on LESDUS, 18 after negative LESDUS, and 15 in unscreened patients. Patients with VTE were older (61y versus 55, P < 0.01), more often male (70.9% versus 29.1%, P = 0.03), had higher ISS (16 versus 10, P < 0.01), longer hospital length of stay (LOS) (11.5 d versus 3, P < 0.01), longer ICU LOS (4.5 d versus 1, P < 0.01), and increased mortality (9.1% versus 4.3%, P = 0.01). RAP was higher in VTE patients versus those without (nine versus three, P < 0.01). RAP >8 was 62.5% sensitive and 70.4% specific for VTE. Chemoprophylaxis delay also correlated with increased VTE (OR = 1.48, 95% CI = 1.03-2.12). Conclusions: VTE remains a significant complication in trauma patients. Despite a universal LESDUS protocol, only 50% of patients underwent screening and 20% of all LE DVTs were not identified on LESDUS. To optimize resource utilization and protocol adherence, LESDUS should only be performed if RAP >8 or if unable to administer timely chemoprophylaxis. (c) 2021 Elsevier Inc. All rights reserved.
Metrics
Details
- Title
- The Utility of Lower Extremity Screening Duplex for The Detection of Deep Vein Thrombosis in Trauma
- Creators
- Amanda L. Teichman - Johnson UniversityDavid Walls - Rutgers, The State University of New JerseyRachel L. Choron - Johnson UniversityChristopher A. Butts - Johnson UniversityNicole Krumrei - Johnson UniversityChristopher Amro - Rutgers Robert Wood Johnson Med Sch, Dept Surg, Div Acute Care Surg, 125 Paterson St,Suite 6300, New Brunswick, NJ 08901 USASneha Swaminathan - Johnson UniversityNicholas Arcomano - Johnson UniversityAkshat Parekh - Johnson UniversityPaul Romeo - Johnson University
- Publication Details
- The Journal of surgical research, v 269, pp 151-157
- Publisher
- Elsevier
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000716303900020
- Scopus ID
- 2-s2.0-85115418374
- Other Identifier
- 991021929441604721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Surgery