This 1994 prospective cohort study used contrast venography to measure DVT frequency in 716 major trauma patients who received no thromboprophylaxis. It asked how common VTE truly is after trauma, and which specific injuries drive the risk. The findings established the epidemiologic foundation for mandatory VTE prophylaxis protocols in trauma care.
A 25-year-old with a tibial fracture and an ISS of 10 is not a low-risk VTE patient. This paper proved it: 77% of unprotected tibial fracture patients developed DVT, and patients under 30 still carried a 46% rate.
Before Geerts et al., VTE rates in trauma were poorly quantified and prophylaxis was inconsistent. This study showed the risk was not only high but nearly universal across injury types, and that clinical surveillance caught fewer than 2% of cases before clots formed.
The clinical decision rule this paper gives you: treat every major trauma patient as high risk from admission, regardless of ISS. Base your prophylaxis decision on injury pattern — femur fracture, tibial fracture, spinal cord injury, and pelvic fracture are your highest-risk triggers.
Three patients died of fatal PE on days 15, 16, and 18 with no prior warning signs, even under active surveillance. This is why trauma services initiate chemical and mechanical prophylaxis at admission rather than waiting for symptoms.
This 1994 prospective cohort study used contrast venography to measure DVT frequency in 716 major trauma patients who received no thromboprophylaxis. It asked how common VTE truly is after trauma, and which specific injuries drive the risk. The findings established the epidemiologic foundation for mandatory VTE prophylaxis protocols in trauma care.
A 25-year-old with a tibial fracture and an ISS of 10 is not a low-risk VTE patient. This paper proved it: 77% of unprotected tibial fracture patients developed DVT, and patients under 30 still carried a 46% rate.
Before Geerts et al., VTE rates in trauma were poorly quantified and prophylaxis was inconsistent. This study showed the risk was not only high but nearly universal across injury types, and that clinical surveillance caught fewer than 2% of cases before clots formed.
The clinical decision rule this paper gives you: treat every major trauma patient as high risk from admission, regardless of ISS. Base your prophylaxis decision on injury pattern — femur fracture, tibial fracture, spinal cord injury, and pelvic fracture are your highest-risk triggers.
Three patients died of fatal PE on days 15, 16, and 18 with no prior warning signs, even under active surveillance. This is why trauma services initiate chemical and mechanical prophylaxis at admission rather than waiting for symptoms.