RISK ASSESSMENT FOR VTE: ALL ARE NOT EQUAL
Journal Title: IJSR-International Journal Of Scientific Research - Year 2019, Vol 8, Issue 5
Abstract
Venous Thromboembolism [VTE] risk assessment has become common in most hospitals. However, the comparison of effectiveness between quantitative and qualitative risk assessments is sparse in the literature. We performed a comparative analysis between a quantitative and qualitative assessment in 146 consecutive adult trauma patients. Of the 146 patients enrolled, 64 of whom had no contraindications to VTE prophylaxis, 99 were men and 47 were women. Mean population age was 52.3 years and mean injury severity score [ISS] was 20.0 (+ 9.9). ISS did not correlate with VTE risk. Elderly patients were found to be at higher risk for development of VTE. The non-quantitative risk assessment assigned 38 low risk, 80 moderate risk and 28 high risk patients. Each grouping was re-evaluated to provide a mean quantitative risk for each category of the non-quantitative assessment: 1.5 points for low risk, 3 points for moderate risk, and 3.96 for high risk. Based on recommended guidelines of the quantitative risk score, adequacy of VTE prophylaxis was assessed for each non-quantitative category: 72.2% for low risk, 64.7% for moderate risk and 58.3% for high risk. After re-evaluating all patients using the quantitative risk score, adequacy of VTE prophylaxis was assessed again: 100% for low risk, 83% for moderate risk, 74% for high risk, and 29% for very high risk. We found that the qualitative assessment tended to underscore the risk and therefore resulted in an under-treatment of the highest risk patients. Our data shows that quantitative assessment is superior to qualitative risk assessment.
Authors and Affiliations
Krishna Akella, Akella Chendrasekhar*
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