LOWER LIMB CAST VENOUS THROMBO-EMBOLISM RISK STRATIFICATION SCORE

Abstract

Patients immobilised in lower limb casts are at risk of venous thrombo-embolism. We have devised a unique patient administered scoring system to provide targeted thrombo-prophylactic therapy based on a patient’s risk factors for thrombo-embolism. This study investigated completion of the risk assessment form and intra-observer error.

We carried out a prospective observational study investigating completion of risk assessment forms in patients attending the fracture clinic who were immobilised in lower limb casts. Each patient completed a form at initial presentation which determined their treatment regime. The patients were asked to complete a second identical form once their plaster was removed together with a short questionnaire asking about ease of use of the risk assessment form.

92 patients were included in the study. The first form was correctly completed by 90 patients (98%) and the second by 89 patients (97%). There was an exact scoring correlation between the two forms in 82% of patients.

93% of patients found the scoring system easy to understand and complete.

We propose that this unique patient administered, venous thrombo-embolism risk assessment form provides a user friendly, practical and reproducible tool for highlighting trauma patients in lower limb casts at increased risk of thromboembolic disease.