Venous Thromboembolism Prophylaxis in Outpatient Lower Limb Fractures and Injuries.
BACKGROUND
The risk of venous thromboembolism (VTE) is a preventable complication of trauma in ambulatory patients requiring temporary lower limb immobilisation. We introduced a VTE risk assessment and management tool in fracture clinics, to help improve appropriate VTE management of trauma patients that do not require hospitalisation. This was based on guidelines published by the College of Emergency Medicine (UK). Clinicians were asked to follow the screening tool and manage patients as per the pathway. We aimed to determine the rate of VTE risk assessment and management of outpatient fracture patients following the introduction of the new assessment tool.


METHODS
We prospectively evaluated a cohort of lower limb fracture patients presenting to a fracture clinic following the introduction of the new VTE risk assessment group and compared it to a retrospective cohort treated prior to the new tool.


RESULTS
Prior to introduction of the new assessment tool only 5 of 30 (16.7%) patients were assessed for VTE risk. After introduction of the VTE screening tool, 27 of 28 patients (96.4%) were assessed for VTE risk (P<0.001).


CONCLUSIONS
We are able to show that implementing a VTE screening tool in an orthopaedic outpatient fracture clinic to patients with lower limb trauma requiring temporary limb immobilisation can improve VTE risk assessment in accordance with current guidelines.
Orthopaedic Department, Blackpool Teaching Hospitals NHS Trust, Blackpool, UK.
Sanil H
SH
Ajwani
Orthopaedic Department, Blackpool Teaching Hospitals NHS Trust, Blackpool, UK.
Alex
A
Shaw
Orthopaedic Department, Blackpool Teaching Hospitals NHS Trust, Blackpool, UK.
Osamah
O
Naiz
Orthopaedic Department, Blackpool Teaching Hospitals NHS Trust, Blackpool, UK.
Deepu
D
Bhaskar
Orthopaedic Department, Blackpool Teaching Hospitals NHS Trust, Blackpool, UK.
Charalambos P
CP
Charalambous
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000601:surgery*; D006801:Humans; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D018570:Risk Assessment; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology*; D055815:Young Adult
D000925:Anticoagulants