Nursing assessment of clients at risk of deep vein thrombosis (DVT): the Autar DVT scale

Abstract

Deep vein thrombosis (DVT) poses a threat to hospitalized clients' recovery. It is preventable and the cost of treating this problem is considerably more than that of preventative practices. Accurate DVT risk assessment facilitates the application of the most appropriate venous thromboprophylaxis. Founded on Virchow's triad of risk factors in the genesis of deep vein thrombosis, the Autar DVT scale was developed as a predictive index. The DVT scale is composed of the following seven risk categories: increasing age, build and body mass index (BMI), immobility, special DVT risk, trauma, surgery and high risk disease. The DVT scale was tested on two trauma wards and the study was essentially a data generating exercise. Clinical data were gathered on 21 clients to validate the reliability, sensitivity and specificity of the DVT scale. Pearson moment correlation coefficient (r) and total percentage agreement (T%) measurement yielded a value of r at 0.98 and a T% ranging between 70% and 87% respectively for both reliability studies. Predictive validity of the scale calculated from a threshold score of 16 achieved 100% sensitivity and 81% specificity. The Autar DVT scale has produced some interesting results and holds considerable promise as a predictive index. However, as this was a small study further testing in diverse clinical areas of a large client population is recommended.

Venous thromboembolism prevention – an update

“…Any patient over the age of 40 years should be considered to be at significant additional risk of surgical thromboembolism. • Mobility is related to aspects of impaired physical mobility and leads to a significant increase in the risk of VTE, (Autar, 1996). This is due to the diminished pumping action of the leg muscles through not walking and of the foot pump through not weight bearing.…”

“…Autar (1996Autar ( , 2003 suggests that a nursing diagnosis of 'potential problem of DVT (VTE)' is insufficient and that risk needs to be objectively assessed for each patient. He has produced a scale consisting of seven distinct categories identified following a literature review of the pathogenesis of DVT: age, mobility, build/ body mass index, special risk, trauma risk, surgical intervention, high risk diseases.…”

Altered Coagulation: A Diagnosis for the Problem of Deep Vein Thrombosis

“…When the high-risk patients go unidentified and the opportunity for appropriate preventive actions is missed, these patients are overlooked (Autar, 1996). Patients who are at high risk for being hypercoagulable and developing a DVT are easily identified, for some of the risks are blatant and well known.…”

“…Using a nursing diagnosis of altered coagulation could make an enormous contribution to the prevention of DVT. Autar (1996) states that identification of risk is essential for initiation of prevention. One way to inaease awareness, assessment, and education for both nurses and patients is to use a risk factor assessment tool.…”

Deep Vein Thrombosis in a Young Marathon Athlete

“…DVT affects 2 million Americans per year and is the third most common cardiovascular disease after coronary artery disease and stroke. 2,3 DVT most commonly appears in the lower extremity and is typically classified as being either proximal (involving the popliteal, femoral, or iliac veins) or distal (involving the calf veins). Proximal DVT is more likely to cause life-threatening pulmo-T T STUDY DESIGN: Resident's case problem.…”