Pulmonary vascular disease & thromboembolism
Targeted prophylactic anticoagulation based on the TRiP(cast) score in patients with lower limb immobilisation: a multicentre, stepped wedge, randomised implementation trial
Authors' conclusion
Patients with a TRiP(cast) score of less than 7 who are not receiving anticoagulation have a very low risk of venous thromboembolism.
Study context
- Population
- ED patients aged ≥18 years with lower limb trauma requiring immobilisation for ≥7 days15 clusters
- Participants
- 2,120 patients
- Comparison
- Targeted anticoagulation by TRiP score vs usual practice
- Intervention phasen = 1,505
- Primary endpoint
- Cumulative rate of symptomatic VTE during the intervention phase in patients with TRiP(cast) score <7 (safe if <1% with upper 95% CI <2%)
- Follow-up
- 3 months
Methodological detailsmulticentre, blinded outcome assessment, 15 EDs in France and Belgium, Included June 16, 2020 to Sept 15, 2021
- Multicentre
- Blinded outcome assessment
- 15 EDs in France and Belgium
- Included June 16, 2020 to Sept 15, 2021
Primary result
As reported in the abstract
Symptomatic VTE, intervention phase, TRiP(cast) score <7 without anticoagulation
Symptomatic VTE rate (n=8/1159)
0.7%
95% CI 0.3–1.4
Further findings
Cumulative symptomatic VTE, control vs intervention phases
- No difference between control and intervention phases
Safety
Bleeding
- No difference between control and intervention phases
Original publication
Targeted prophylactic anticoagulation based on the TRiP(cast) score in patients with lower limb immobilisation: a multicentre, stepped wedge, randomised implementation trial. Lancet. Published 15 February 2024. doi:10.
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