2. VTE in medicine department
Venous tromboembolism (VTE) prophylaxis is less frequent in emergency medicine (EM) than in internal medicine (IM) department.
Statistically, such difference was substantial in case of immobilization and when was adopted the Padua Score that assigns a higher score at immobilization criterion.

3. VTE in medicine department
The aim of the present study is a critically revue of thromboembolism criteria and score in the medical patient, in EM and IM department.
Particularly we hope find a score more “suitable” for acute patient but with high sensibility and specificity.

4. TEVere Study
double case-control observational study, with enrollment, for each case of VTE, of two consecutive patients without VTE, of equal sex and age group (18-50, 50-55, 55-60, 60-65, 65-70,70-75, 75-80, >80 years)
the study involved EM and IM department of 23 hospital/university of Lazio and Umbria, in Italy.

5. physiographic catchment
“Tevere” river:
physiographic catchment

6. TEVere study – overall population
Le schede raccolte sono state complessivamente 537: 187 casi di TEV e 350 casi controllo.

7. TEVere study -
Le schede raccolte sono state complessivamente da parte delle Unità Operative di Medicina Interna, 370 da parte delle Unità Operative di Medicina d’Urgenza e Pronto Soccorso

8. TEVere study ok

9. (risultati complessivi)
TEV risk factor p <0.01
TEVere
(risultati complessivi)

10. TEV risk factor p <0.01
TEVere Study

11. TEV risk factor < 0.05 (but >0.01)
TEVere Study

12. TEVere Score 3 2 drug that stimulate hematopoiesis, CVC 1
Cancer 3
Previous VTE
Thrombophilia
Major surgery (<60 days) 2
drug that stimulate hematopoiesis, CVC
BMI > 30 Kg/m2 1
Immobilization
Hormone therapy
Age > 70 aa
The “TEVere” score, differently from Padua, assigns a low score to the immobilization criterion, but the predictivities keeps high

13. TEVere Study: Score comparison: specificity and sensitivity
cut off standard
SE%
SP%
CC %
other cut off
Chopard 3
64.2
57.7
60.0 4
43.9
72.9
62.8
Kucher
25.1
92.9
69.3
40.6
90.0
72.8
ACCP -
23.0
88.6
65.4
Padova
52.4
72.3 5
35.29 82
65.7
TEVere
44.39
89.43
73.7
The “TEVere” score, differently from Padua, assigns a low score to the
immobilization criterion, but the predictivities keeps high

14. Padua Prediction Score
Barbar S t al . J Thromb Haemost ; 8 ( 11 ): 2450 –

15. TEVere Score vs Kucher score

16. TEVere Score: consideration
The criterion of immobilization, very important, but is difficult assignment in the departments of emergency medicine and short observation because there is often no time for the allocation of this risk criterion.
The “TEVere” score could therefore represent the ideal score in the afferent patients to the EM department, even if the are necessary further validation studies.

17. Pater Tiberinus, Adrianea age. Louvre17