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Tuesday 17 October 2017
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Dr Dan Horner
Dr Dan Horner, Consultant in Emergency Medicine and Critical Care

#SalfordWTD: Thrombosis and Anticoagulation research

There are multiple thrombosis and bleeding research studies ongoing both at Salford Royal and across the region, led by members of our Trust Thrombosis Committee. Dr Dan Horner, Consultant in Emergency Medicine and Critical Care, updates us on four such pieces of work:

 

  • In the Emergency Department, the Trust is currently collaborating with Roche on a commercial study, looking to assess the diagnostic performance of a blood test in the diagnosis of venous thromboembolism (VTE). This study recruits all patients with a moderate or low pre-test clinical probability score. So far we have screened more than 200 patients and recruited more than 15 patients. We have also recently met with the sponsor to discuss new ways of increasing recruitment rates, and have introduced research nurse led screening and calculation of the Wells clinical probability score.
  • The Emergency Department has also recently completed a project on the clinical utility of introducing an age adjusted cut point for d-dimer (a type of protein) testing, to reduce the burden of investigation and treatment in VTE. An age adjusted cut point would mean that patients over the age of 50 could have a deep vein thrombosis or pulmonary embolism excluded in the emergency department more often, without the use of invasive testing, long waits for imaging or anticoagulant drugs. Results have been presented at an international conference and publication of the findings is expected shortly. 
    Have you seen the current literature on the use of age adjusted d-dimer cut points? Have a look at our policy document for more information and references.
  • Salford clinicians are also directly leading on the TiLLI project, a research initiative funded by the Health Technology Association. This project aims to evaluate the clinical and cost effectiveness of using pharmacological thromboprophylaxis to reduce the risk of subsequent VTE after lower limb injury and temporary immobilisation in plaster or boot. 
  • Members of the VTE committee are also working with the University of Manchester to improve outcomes following intracranial haemorrhage. This important work takes the form of an embedded multicentre observational study, and a programme combining implementation science with health informatics – which aims to ensure optimal delivery of best practice, through improved recognition and reliable delivery of secondary prevention. 


 


Dr Horner has been awarded the Royal College of Emergency Medicine Professorship. This is in recognition of his research portfolio, and comes with a research grant to further his work (including the TiLLI project, above). Please read more about Dr Horner's professorship on the Salford R+D website. 

 

#SalfordWTD for World Thrombosis Day, 13 October 2017