Individual risk factors predictive of venous thromboembolism in patients with temporary lower limb immobilization due to injury: a systematic review
Author(s): ,
Daniel Horner
Affiliations:
Emergency Department, Salford Royal NHS Foundation Trust, Salford, UK. School for Health and Related Research, The University of Sheffield, Sheffield, UK. The Royal College of Emergency Medicine, London, UK
Correspondence: Daniel Horner, Emergency Department, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.|Tel.: +01 61 206 8793|E‐mail: danielhorner@nhs.net
,
Abdullah Pandor
Affiliations:
School for Health and Related Research, The University of Sheffield, Sheffield, UK
,
Steve Goodacre
Affiliations:
School for Health and Related Research, The University of Sheffield, Sheffield, UK
,
Mark Clowes
Affiliations:
School for Health and Related Research, The University of Sheffield, Sheffield, UK
Beverley J. Hunt
Affiliations:
Thrombosis and Haemophilia Centre, St Thomas' Hospital, London, UK
ISTH Academy. Horner D. Feb 8, 2019; 273375
Dr. Daniel Horner
Dr. Daniel Horner
Login now to access Regular content available to all registered users.

Access to Premium content is currently a membership benefit.

Click here to join ISTH or renew your membership.

You may also access ISTH content "anytime, anywhere" with the FREE ISTH Academy App for iOS and Android.
Journal Abstract
Discussion Forum (0)
Rate & Comment (0)


Background
Patients immobilized after lower limb injury are at risk of venous thromboembolism (VTE). There is international variation in the use of thromboprophylaxis for such patients. Risk‐based strategies have been adopted to aid decision making in many settings. The accuracy of these strategies is unclear.
Objectives
A systematic review was undertaken to identify all individual patient‐identifiable risk factors linked to any VTE outcome following lower limb immobilization.
Methods
Several electronic databases were searched from inception to May 2017. Any studies that included a measurement of VTE as a patient outcome in adults requiring temporary immobilization (e.g. leg cast or brace in an ambulatory setting) for an isolated lower limb injury and reported risk factor variables were included. Descriptive statistics and thematic analysis were used to synthesize the evidence.
Results
Our database search returned 4771 citations, of which 15 studies reporting outcome data on 80 678 patients were eligible for analysis. Risk‐factor associations were reported through regression analyses, non‐parametric tests and descriptive statistics. All studies were assessed as at moderate or serious risk of bias using the ROBINS‐I risk of bias tool.
Conclusions
Clinicians should be aware of the limited evidence to support individual risk factors in guiding thromboprophylaxis use for this patient cohort.
Keyword(s)
casts, immobilization, risk, surgical, venous thromboembolism
Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies