Die tiefe Beinvenenthrombose in der Unfallchirurgie - eine prospektive Analyse von Inzidenz, Risikofaktoren und Prophylaxe an 438 konsekutiven Patienten an der Unfallchirurgischen Abteilung der Universität Ulm

Abstract

A number of 438 patients admitted to the Trauma Department of the University of Ulm were examined with color coded ultrasound for the presence of deep vein thrombosis (DVT) either on the day before their demission or when clinically deep vein thrombosis was suspected. Before a risk pattern for DVT was assessed using a questionnaire, standard thrombosis prophylaxis with low molecular weight heparin and / or mechanical devices was used in most of the patients. A total number of 15 new DVT representing an incidence rate of 3,24 % was detected. Risk factor analysis showed elevated risk for deep vein thrombosis when trauma took place in the bone column, hip or lower limb region, when trauma was connected with bone fractures or prolonged immobilization or in presence of individual co-morbidities. When these conditions occurred in combination, the risk for deep vein thrombosis was especially high. Despite combination of different prophylaxis measurements the occurrence of DVT could not be avoided in some patients with a high thrombogenetic risk profile. There is hope that a calculation model combining thrombosis risk factors can help to determine an individual thrombosis risk level.