Ithaca College, NY.
J Athl Train. 2018 May;53(5):497-502. doi: 10.4085/1062-6050-362-16. Epub 2018 Jun 12.
Although athletes are typically at low risk for developing venous thromboembolism (VTE), injured and noninjured athletes alike can be exposed to many acquired risk factors, including intense training, dehydration, trauma, immobilization, oral contraceptive use, and long-distance travel. Additionally, the risk of developing VTE might be increased by unidentified genetic clotting disorders. Due to the potential for fatal outcomes, knowledge of VTE pathoetiology and recognition of deep vein thrombosis (DVT) presentation should be an inherent part of the evaluation process for all who attend to athletes, regardless of age and apparent risk profile.
To present an exploration clinical case series consisting of 2 otherwise healthy, college-aged female athletes who, despite their ages and relative low risk profiles, experienced DVTs after lower extremity trauma. Each case will be discussed relative to known clinical prediction rules (CPRs) and published evidence.
Collectively, both cases reinforce the need for the attending clinicians to perform a thorough history and pay attention to subtle clinical findings, regardless of the relatively low risk in college-aged athletes. Although the Wells' CPRs for DVT can be used as a diagnostic guideline in the general population, it might not fully address the risks inherent in a young, otherwise healthy athletic population. We propose a risk-screening tool that is based on and modified from our experiences with these 2 patients and the known prediction rules and positive probability influences.
尽管运动员发生静脉血栓栓塞（VTE）的风险通常较低，但受伤和未受伤的运动员都可能面临许多获得性风险因素，包括剧烈训练、脱水、创伤、固定、口服避孕药的使用和长途旅行。此外，由于未识别的遗传凝血障碍，发生 VTE 的风险可能会增加。由于存在致命后果的可能性，了解 VTE 的病理生理学和识别深静脉血栓形成（DVT）的表现应该是评估所有运动员的固有部分，无论年龄和明显的风险概况如何。
介绍一个由 2 名其他健康的、大学年龄的女性运动员组成的临床病例系列，尽管他们年龄相对较小，风险较低，但在下肢创伤后发生了 DVT。每个病例将根据已知的临床预测规则（CPR）和已发表的证据进行讨论。
总的来说，这两个病例都强调了主治医生需要进行彻底的病史检查，并注意细微的临床发现，无论在大学年龄的运动员中风险相对较低。尽管 Wells DVT 的 CPR 可用于一般人群的诊断指南，但它可能无法完全解决年轻、健康的运动员人群中固有的风险。我们提出了一个基于我们对这 2 名患者的经验以及已知的预测规则和阳性概率影响的风险筛查工具。
