ASYMPTOMATIC DEEP VENOUS THROMBOSIS IN THE TRAUMA PATIENT - IS AN AGGRESSIVE SCREENING PROTOCOL JUSTIFIED

The incidence and sequelae of deep venous thrombosis (DVT) in trauma p atients are unclear because the majority of patients who develop DVT a re asymptomatic. This study evaluated the incidence, risk factors, and efficacy of prophylaxis for DVT in trauma patients over a 5-year peri od. Trauma patients at high risk for DVT were evaluated biweekly with lower extremity venous duplex scans. The DVT prophylaxis was institute d on admission with low-dose heparin therapy and pneumatic compression . The incidence of asymptomatic DVT identified by duplex screening was 10% (45 of 458); one pulmonary embolus occurred. Five variables were significant from bivariate and multiple logistic regression analysis: age (p = 0.005). Injury Severity Score (p = 0.005), length of stay (p = 0.004). Trauma and Injury Severity Score (p = 0.01), and spinal inju ry (p = 0.014). This analysis documents that trauma patients with thes e risk factors are at increased risk for the development of asymptomat ic DVT, despite prophylaxis, and warrant surveillance with venous dupl ex sonography.