The role of surveillance duplex scanning in preventing venous thromboembolism in trauma patients

BACKGROUND: This study was performed to determine the role of duplex scanning in preventing pulmonary embolism (PE), the correlation of venous thromboembolism (VTE) risk score with the incidence of deep venous thrombosis (DVT), and patients who may benefit from surveillance duplex scanning. METHODS: Age, sex, Injury Severity Score (ISS), VTE score, length of stay, diagnoses, and bleeding risk were recorded from the trauma registry in patients who had a duplex scan from 1995 to 2000. RESULTS: There were 1,513 duplex scans obtained (10,141 trauma admissions), 253 (2.5%) cases of DVT (52% above-knee, 8% upper extremity), and 30 cases of PE (0.3%). Only 5 of 21 duplex scans were positive in PE patients. DVT patients were older (52.9 vs. 46.7 years), with higher ISS (24.0 vs. 20.8) than patients without DVT. Regression analysis showed poor correlation between VTE score and DVT incidence (r2 = 0.27). Univariate analysis identified age, ISS, and VTE score as risk predictors for DVT. CONCLUSION: Adherence to an evidence-based VTE prophylaxis protocol is more important than surveillance duplex scanning in preventing VTE in trauma patients.