ROLE OF VENOUS THROMBOEMBOLISM (VTE) PROPHYLAXIS

Utilizing the DoDTR, the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in the U.S. military combat casualty population with DCBI is 3.3% and 3.6%, respectively. In those severely injured who required lower extremity amputation(s), the DVT and PE incidence increased to 11.2% and 13.7%. Every patient with a proximal amputation has, by definition, a DVT. Therefore, it is recommended that DCBI patients be started on appropriate VTE prophylaxis as soon as coagulopathy is resolved. If contraindications to prophylactic anticoagulation persist, prophylactic inferior vena cava filter placement should be considered.

Refer to JTS Prevention of Venous Thromboembolism CPG for further guidance.27