Yonsei Med J.  2021 Jun;62(6):520-527. 10.3349/ymj.2021.62.6.520.

Venous Thromboembolism in a Single Korean Trauma Center: Incidence, Risk Factors, and Assessing the Validity of VTE Diagnostic Tools

• Boo S
• Oh H
• Hwang K
• Jung K
• Moon J

• KMID: 2516084
• DOI: http://doi.org/10.3349/ymj.2021.62.6.520

Abstract

Purpose
Trauma increases the risk of venous thromboembolism (VTE) in hospitalized patients. However, the risk and incidence of VTE in Korean trauma patients are limited. Therefore, we aimed to evaluate the incidence and identify potential predictors of VTE occurrence in Korean trauma patients. Moreover, we assessed the validity of the Greenfield risk assessment profile (RAP) and the trauma embolic scoring system (TESS) in these patients.
Materials and Methods
This retrospective cohort study used the data of trauma patients who were admitted to a regional trauma center between 2010 and 2016 and were eligible for entry into the Korea Trauma Data Bank. Clinical data were collected from hospital medical records. The patient’s baseline characteristics and clinical data were compared between VTE and non-VTE groups.
Results
We included 9472 patients. The overall VTE rate was 0.87% (n=82), with 56 (0.59%) events of deep vein thrombosis and 39 (0.41%) of pulmonary embolism. Multiple regression analysis revealed that variables, including VTE history, pelvic-bone fracture, ventilator use, and hospitalization period, were significant, potential predictors of VTE occurrence. This study showed that increased RAP and TESS scores were correlated with increased VTE rate, with rates of 1% and 1.5% for the RAP and TESS scores of 6, respectively. The optimal cut-off value for RAP and TESS scores was 6.
Conclusion
RAP and TESS, which are well-known diagnostic tools, demonstrated potentials in predicting the VTE occurrence in Korean trauma patients. Additionally, patients with pelvic-bone fractures and long-term ventilator treatment should be carefully examined for possible VTE.

Keyword

Venous thromboembolism; multiple trauma; incidence; pulmonary embolism; prevention