Observational studyPloS one2019
Venous thromboembolism risk stratification for patients with lower limb trauma and cast or brace immobilization.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Prevention of venous thromboembolic events in patients with lower leg immobilization after trauma: Systematic review and network meta-analysis with meta-epsidemiological approach.PLoS medicine · 2022Pooled it
- Thromboprophylaxis in Non-operative Lower-Limb Immobilization: Risk Stratification Identifies Whom to Spare, Not Whom to Treat - A Narrative Review.Journal of orthopaedic case reports · 2026Article
- Development and validation of the CHI-CAT score: a novel tool for assessing cancer-associated venous thromboembolism risk in China.BMC cancer · 2025Article
- Article
- Minor trauma and venous thromboembolism: the threshold for antithrombotic prophylaxis.Haematologica · 2024Review
- Targeted proteomics for evaluating risk of venous thrombosis following traumatic lower-leg injury or knee arthroscopy.Journal of thrombosis and haemostasis : JTH · 2022Article
- Article
- Prediction of venous thromboembolism in patients with lower-limb immobilization.EClinicalMedicine · 2020Article
- Clinical risk assessment model to predict venous thromboembolism risk after immobilization for lower-limb trauma.EClinicalMedicine · 2020Article
- What's new in VTE risk and prevention in orthopedic surgery.Research and practice in thrombosis and haemostasis · 2020Article
- Thromboprophylaxis in lower limb immobilisation after injury (TiLLI).Emergency medicine journal : EMJ · 2020Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThromboprophylaxis for patients with non-surgical isolated lower-limb trauma requiring immobilization is a matter of debate. Our aim was to develop and validate a clinical risk- stratification model based on Trauma, Immobilization and Patients' characteristics (the TIP score).
methodsThe TIP score criteria and the cut-off were selected by a consensus of international experts (n = 27) using the Delphi method. Retrospective validation was performed in a population-based case-control study (MEGA study). The potential score's impact in anticoagulant treatment was assessed in a prospective single-center observational cohort study.
findingsAfter four successive rounds, 30 items constituting the TIP score were selected: thirteen items for trauma, three for immobilization and 14 for patient characteristics were selected, each rated on a scale of 1 to 3. In the validation database, the TIP score had an AUC of 0·77 (95% CI 0.70 to 0.85). Using the cut-off proposed by the experts (≥5) and assuming a prevalence of 1·8%, the TIP scores had a sensitivity, specificity and negative predictive values of 89·9%, 30·7% and 99·4% respectively. In the prospective cohort, 84·2% (165/196) of all the patients concerned who presented at the emergency department had a low VTE risk not requiring thromboprophylaxis according to their TIP scores. The 3-month rate of symptomatic VTE was 1/196 [95% CI 0.1-2.8] this patient was in the sub-group TIP score ≥5.
conclusionFor patients with non-surgical lower-limb trauma and orthopedic immobilization, the TIP score allows an individual VTE risk-assessment and shows promising results in guiding thromboprophylaxis.
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