Thrombotic Risk Evaluation and Management Form to prevent deep vein thrombosis after pelvic & acetabular fractures

Abstract

Objective To explore the clinical value of self-designed Thrombotic Risk Evaluation and Management Form in prevention of deep vein thrombosis (DVT) after pelvic & acetabular fractures.Methods From January 2009 to April 2010, 215 patients with pelvic & acetabular fractures were included in this study to assess the clinical value of Thrombotic Risk Evaluation and Management Form. Among them,119 patients who did not use the form served as controls. Their mean age was 39. 7 (ranging from 18 to 84)years. Nineteen of them were complicated with chronic diseases. The other 96 patients who used the form served as subjects for the assessment. They had a mean age of 37.5 (ranging from 18 to 85) years. Thirteen of them were complicated with chronic diseases. There was no significant difference in preoperative demographic characteristics or injury status between the 2 groups (P ＞ 0.05). Comparisons were made between the 2 groups in respects of thrombo-prophylaxis, prophylactic effect, D-dimer testing and duplex sonography screening. Results The proportions of patients receiving prophylaxis in the control and assessment groups were 30.3% and 54. 2% respectively. 10.9% of the patients in the control group had therapy to promote blood circulation while 26.0% in the assessment group did. The duplex sonography screening identified DVT in 15. 1 % of the controls but only 6.3% in the assessment group, with a significant difference (P ＜ 0.05). In the control group, 11 and 25 patients received D-dimer assay and ultrasound examination respectively, while in the assessment group 41 and 32 patients did, with significant differences (P ＜ 0.05). Anticoagulant administration started significantly earlier in the assessment group (4.2 ± 3.9 days) than in the control group (6.6 ± 3.9days) (t = 2.240, P = 0.020). Conclusion The Thrombotic Risk Evaluation and Management Form can significantly improve the clinician's awareness of thrombo-prophylaxis and the prophylactic effect. Key words: Venous thrombosis; Pelvis; Fractures; Risk assessment; Preventive medicine