The risk assessment profile score identifies trauma patients at risk for deep vein thrombosis

Background. The identification of trauma patients at risk for the developme nt of deep venous thrombosis (DVT) at the time of admission remains difficu lt. The purpose of this study is to validate the risk assessment profile (R AP) score to stratify patients for DVT prophylaxis. Methods. All patients admitted from November 1998 thru May 1999 were evalua ted for enrollment. We prospectively assigned patients as low risk or high ris for DVT using the RAP score. High-risk patients received both pharmacol ogic and mechanical prophylaxis. Low-risk patients received none. Surveilla nce duplex Doppler scans were performed each week of hospitalization or if symptoms developed. Hospital charges for prophylaxis were used to determine the savings in the low-risk group. Statistical differences between the ris k groups for each factor of the RAP and development of DVT were determined by the chi squared test, with significance at a probability value of less t han .05. Results. There were 102 high-risk (64%) and 58 low-risk (36%) individuals s tudied. Eleven of the high-risk group (10.8%) experienced the development o f DVT (asymptomatic, 64%). None of the low-risk group was diagnosed with DV T. Five of the 16 RAP factors were statistically significant for DVT. Elimi nating prophylaxis and Doppler scans in low-risk patients resulted in a tot al savings of $18,908 in hospital charges. Conclusions. The RAP score correctly identified trauma patients at increase d risk for the development of DVT Despite prophylaxis, the high-risk group warrants surveillance scans. Withholding prophylaxis in low-risk patients c an reduce hospital charges without risk.