| Title: |
Venous thromboembolism prophylaxis practices and outcomes at an Australian level-one trauma service. |
| Authors: |
Hamilton, Jordan, Cocco, Annelise, Shakerian, Rose, Wu, Michael, Wang, Jennifer, Gumm, Kellie, Read, David J |
| Source: |
Trauma; Oct2022, Vol. 24 Issue 4, p308-315, 8p |
| Subject Terms: |
THROMBOEMBOLISM prevention, VEINS, TRAUMA centers, MORTALITY, INTRACRANIAL hemorrhage, RETROSPECTIVE studies, ACQUISITION of data, TREATMENT effectiveness, RISK assessment, THROMBOEMBOLISM, EMERGENCY medical services, MEDICAL records, DISEASE prevalence, DESCRIPTIVE statistics, CHEMOPREVENTION |
| Geographic Terms: |
AUSTRALIA |
| Abstract: |
Background: Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major cause of potentially preventable morbidity and mortality amongst trauma patients. Venous thromboembolism prevalence varies from 1 to 58%, and traditionally, compliance with prophylaxis protocols is low in major trauma cohorts. This study aimed to describe VTE prevalence, prophylaxis practices and outcomes amongst VTE cases at an Australian level-one trauma centre. Methods: A retrospective review of all VTE cases occurring in acute, major trauma admissions between 1 January 2010 and 30 June 2019 was conducted using prospectively collected registry data. Data regarding demographics, time to diagnosis, VTE prophylaxis, VTE risk assessment tool (RAT) usage and all-cause mortality were collected. Chemoprophylaxis was considered adequate if administered for 48 h prior to diagnosis. VTE cases diagnosed within 48 h of admission were excluded from prophylaxis compliance analysis. A subgroup analysis of patients with intracranial haemorrhage (ICH) was also completed. Results: During the study period, 238 VTE events occurred in 237 patients from 7482 major trauma admissions, giving a VTE prevalence of 3.18%. The all-cause mortality rate was 8.0%. VTE chemoprophylaxis was administered for 109 of 211 eligible patients (51.7%). Of the remaining 102 VTE cases, 75 (73.5%) did not receive prophylaxis due to a documented contraindication, while 27 (26.5%) did not receive prophylaxis with no contraindication recorded. The VTE RAT was completed in 49.0% of cases. Conclusion: Venous thromboembolism prevalence at our institution was consistent with published figures for comparable institutions. A review of compliance with prophylaxis protocols showed several potential areas for improvement. [ABSTRACT FROM AUTHOR] |
|
Copyright of Trauma is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Complementary Index |
