Pulmonary Embolism Clinical Trial
Official title:
Prospective Study to Assess the Foreseeable Impact of TIP Score on Thromboprophylaxis in Patients With Isolated Non-surgical Lower Limb Trauma Compared to the Physicians' Judgment in Standard Practice.
Traumatic lesions are the leading causes of admission to the emergency center (39%), isolated
non-surgical lower limbs trauma are in the foreground. Two recent meta-analyzes suggest the
value of Low Molecular Weight Heparins (LMWH) which would reduce symptomatic Thromboembolism
Events (TE) in patients with lower limb trauma. However, many recent studies conclude to the
need of stratifying the TE risk according to the patient and the nature of his trauma to
obtain an individualized therapeutic decision.
The retrospectively established L-TRIP (cast) score allows stratification of the risk without
taking into account the type of trauma. The TIP score (Trauma, Immobilization and Patient)
was established by consensus of international experts via the Delphi method.
We suggest that the application of the TIP score to rationalize indications of
thromboprophylaxis in patients with isolated non-surgical trauma of a lower limb should
reduce the rate of anticoagulation prescription without increasing the risk of symptomatic
thromboembolic complications with a direct benefit for patients and medico-economic for the
society.
All patients admitted to the Emergency Departments for a nonsurgical isolated lower limb
trauma necessitating rigid or semi-rigid immobilization, will be assessed for possible
participation.
After the physicians had obtained the no-opposition of the patient, they will fill a
questionnaire. This questionnaire includes the treatment chosen by the physician, the type of
trauma, the type of immobilization chosen, and the patient's thromboembolic risk factors in
order to calculate the TIP and L-TRIP (cast) scores retrospectively.
Phone follow-up will occur within 3 months to gather clinical event data (any signs of VTE,
any bleeding events).
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