The Risk Assessment Profile is suboptimal for guiding duplex ultrasound surveillance in trauma patients

Abstract

The utility of the Risk Assessment Profile (RAP) score in predicting VTE was assessed, and VTE risk factors identified to guide a duplex ultrasound (DUS) protocol in injured patients. Secondary analysis of prospective data on trauma inpatients (March 2017 - September 2019), with admission RAP ≥5. Inhospital VTE patients compared to those without. Regression analyses in DVT, PE and proximal DVT, and ROC analysis evaluating RAP's VTE predictability were performed. 1,989 patients were analyzed. VTE was identified in 163(8.2%), DVT 159(8.0%), and PE 10(0.5%) patients. Strongest VTE predictors were massive transfusion (OR 5.97, p=0.005) and spinal cord injury (OR 2.43, p=0.03). AUC 0.61 (p<0.001) on ROC analysis evaluating RAP on VTE. Abdominal injury and major surgery were unique risk factors to non-screened patients. Performance of RAP to predict VTE was moderate. VTE predictor variables could serve as the foundation for a novel approach guiding DUS surveillance. Derivation and validation are warranted.