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.