RT Journal Article
SR Electronic
T1 Thromboprophylaxis in lower limb immobilisation after injury (TiLLI)
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 36
OP 41
DO 10.1136/emermed-2019-208944
VO 37
IS 1
A1 Daniel Horner
A1 Steve Goodacre
A1 Abdullah Pandor
A1 Timothy Nokes
A1 Jonathan Keenan
A1 Beverley Hunt
A1 Sarah Davis
A1 John W Stevens
A1 Kerstin Hogg
YR 2020
UL http://emj.bmj.com/content/37/1/36.abstract
AB Venous thromboembolic disease is a major global cause of morbidity and mortality. An estimated 10 million episodes are diagnosed yearly; over half of these episodes are provoked by hospital admission/procedures and result in significant loss of disability adjusted life years. Temporary lower limb immobilisation after injury is a significant contributor to the overall burden of venous thromboembolism (VTE). Existing evidence suggests that pharmacological prophylaxis could reduce overall VTE event rates in these patients, but the proportional reduction of symptomatic events remains unclear. Recent studies have used different pharmacological agents, dosing regimens and outcome measures. Consequently, there is wide variation in thromboprophylaxis strategies, and international guidelines continue to offer conflicting advice for clinicians. In this review, we provide a summary of recent evidence assessing both the clinical and cost effectiveness of thromboprophylaxis in patients with temporary immobilisation after injury. We also examine the evidence supporting stratified thromboprophylaxis and the validity of widely used risk assessment methods.