Development of the Plymouth VTE Risk Score for patients treated with lower limb immobilisation in a cast or boot |
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| Institution: | 1. Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, 6 Jiefang Street, Dalian, Liaoning 116001, China;2. Department of Orthopaedics, Yantai Hospital of Shandong Wendeng Orthrpaedics & Traumatology, Shanhai South Road, Laishan district, Yantai 264003, Shandong Province, China;1. Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan;2. Department of Linguistics, Indiana University, Bloomington, IN, USA;3. Prehospital Emergency Care Center, Mackay Memorial Hospital, Taipei, Taiwan;4. Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, South Korea;5. Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia;6. Department of Emergency Medicine, National Taiwan University Hospital, Yunlin Branch, Douliu City, Taiwan;7. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan;1. Department of Orthopaedic Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China;2. Department of Traumatology, Surgical Division, University Medical Centre, Ljubljana, Slovenia;1. University of Bari “Aldo Moro”. Department of Basic Medical Sciences, Neuroscience and Sense Organs. Orthopaedic and Trauma Unit, Piazza Giulio Cesare, 11. 70124. Bari, Italy;2. Orthopaedic and Trauma Unit, Humanitas Research Hospital, Milano, Italy;1. Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People''s Hospital, NO. 600, Yishan Rd., Shanghai, 200233, P.R.China;2. Department of Orthopedic Surgery, Pudong New Area Peoples’ Hospital affiliated to Shanghai University of Medicine&Health Sciences, No.490 Chuanhuan South Rd., Shanghai 201299, China;3. Department of Orthopedic Surgery, Songjiang District Central Hospital, No.746 Zhongshan Middle Rd., Shanghai 201600, China;4. Department of Orthopedic Surgery, Tongji University School of Medicine, Tongji Hospital, No.200 People''s Avenue, Shanghai , 200065, China |
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| Abstract: | There is approximately a 2% risk of clinically significant VTE following temporary lower limb immobilisation after injury with an ankle immobilising plaster cast or boot. There is evidence that thromboprophylaxis for lower limb immobilised patients reduces the risk of VTE by approximately 50% but there is no international consensus as to which patients should receive thromboprophylaxis. The Plymouth VTE Risk Score was developed to identify patients at particular risk of VTE, in order to offer chemical prophylaxis to reduce their VTE risk. The score showed high completion rates, reliability and consistency. Using the Plymouth VTE Risk Score Version 3 (2014), we found an incidence of clinical VTE of 0.36% with 37.6% of patients being advised to have thromboprophylaxis. This is a lower VTE incidence than in most other studies of this patient group, which is of the order of 2 to 3%. The optimal RAM to use in clinical practice is yet to be defined, further clinical research is needed to accurately stratify patient risk and to define optimal risk treatment levels. We suggest research should focus on comparative clinical studies of risk assessment models. |
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