Grant: Project Grant - Priority Announcement: Female Athlete Health

Orthopaedic injuries are common and patients who require surgery are at risk of developing blood clots in the legs (called deep vein thromboses) or blood clots in the lungs (called pulmonary embolism). Despite the use of blood thinning medication, up to 12% of patients undergoing surgery for a leg injury experience a blood clotting complication. Currently, medical guidelines differ on who should receive blood thinning medications, leading to potential over- or under-treatment. The Trauma, Immobilisation, and Patient (TRiP) cast scoring system has been used to evaluate individual blood clotting risk after an injury to determine if blood thinning medication would be beneficial. However, this score has not been used for patients requiring surgery. Our prior research in patients with hip fractures used a simple blood test (called thrombelastography, or TEG) to measure how quickly and effectively blood forms clots. Therefore, we propose to use TEG in the same way to decide if this blood test can improve the ability of the TRiP cast score to identify which patients would benefit from blood thinning medication after surgery for their leg injury. We will recruit adult patients with leg injuries requiring surgery from 4 hospitals across Canada. Each participant will undergo a risk assessment using the TRiP cast score and have blood tests analyzed by TEG. We will monitor participants over a 90-day period to observe any blood clotting or bleeding complications. This study is unique because it combines a clinical risk assessment tool (TRiP cast score) with an advanced blood test (TEG) to develop a personalized strategy for preventing blood clots. Our research team includes physicians, scientists, and patient partners. By focusing on individualized risk factors, we aim to move away from a one-size-fits-all approach to blood clot prevention, potentially setting a new standard for personalized patient care in this area.