Clinical Risk Factors of Asymptomatic Deep Venous Thrombosis in Patients With Acute Stroke

Background: Deep venous thrombosis (DVT) is a common complication after stroke. It is easy to identify the patients with symptomatic DVT; however, the tool for asymptomatic high-risk population needs to be further explored. Our aim was to explore the risk factors of acute stroke patients with asymptomatic DVT. Methods: We performed a prospective observation study among 452 patients with acute stroke who had a stroke within 14 days. Ultrasound examination of deep veins was repeatedly performed in each patient for DVT every 7 days during his admission. The dynamic rate of DVT in acute stroke was analyzed. Then risk factors were compared between DVT patients and non-DVT patients. The predictive model was explored based on thr cox proportion model. Results: Asymptomatic DVT was detected in 52 (11.5%) patients with stroke and 85.9% of thrombi were identified in their distal veins. Patients with longer length of stay ( P = .004), more severe stroke ( P = 0.001), higher level of D-dimer ( P = .003), and higher blood glucose level were associated with higher risk of DVT, while patients with higher triglyceride level ( P = .003) were less likely to have DVT, after adjusting age and sex. With the median of D-dimer (0.38 FEU mg/L) as cutoff value. Patients with higher level of D-dimer might have a higher risk of DVT with a significant statistical difference. Also, the severity of stroke differed DVT risk in Kaplan-Meier model. Using cox-proportion hazard regression model, asymptomatic DVT could be predicted (area under the curve 0.852). Conclusion: Our data showed that asymptomatic DVT was common in patients with acute stroke and most of thrombosis occurred in distal veins. Combination of clinical manifestation and laboratory results might be helpful predict DVT. DVT prophylaxis should be condisdered in high risk.

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Evaluation of stability of deep venous thrombosis of the lower extremities using Doppler ultrasound

Journal of International Medical Research ◽

10.1177/0300060520942098 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052094209

Author(s):

Shefang Zhang ◽

Wen Chu ◽

Hua Wang ◽

Yajun Liang ◽

Yajuan Fan ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Body Mass ◽

Doppler Ultrasound ◽

Area Under The Curve ◽

Lower Extremities ◽

Smoking History ◽

D Dimer

Objective This study aimed to assess using Doppler ultrasound for analyzing stability of deep venous thrombosis (DVT) of the lower extremities. Methods Patients with DVT of the lower extremities who were treated from August 2017 to December 2019 were selected. The patients were divided into stable and unstable groups according to whether thrombus was collected in a filter. Related ultrasound and blood test results were analyzed and compared. Results A total of 126 patients with DVT of the lower extremities were included, of whom 74 were in the stable group and 52 were in the unstable group. There were significant differences in the prothrombin time (PT), and lipoprotein alpha, D-dimer, and triglyceride levels between the groups. D-dimer levels >2800 ug/L, smoking, history of venous thrombosis, PT >13.15 s, and body mass index >24.45 kg/m2 were independent risk factors for stability of DVT of the lower extremities. The area under the curve with combined detection of DVT was significantly higher than that for body mass index, PT, and D-dimer alone. Conclusion Doppler ultrasound may be reliable for analyzing the stability of DVT of the lower extremities. Related strategies targeting risk factors are required for reducing DVT of the lower extremities.

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The Use of Indium-111 Labeled Platelet Scanning for the Detection of Asymptomatic Deep Venous Thrombosis in a High Risk Population

Orthopedics ◽

10.3928/0147-7447-19891101-08 ◽

1989 ◽

Vol 12 (11) ◽

pp. 1439-1443

Author(s):

Robert S Siegel ◽

Janice L Rae ◽

Nancy L Ryan ◽

Cherie Edwards ◽

William P Fortune ◽

...

Keyword(s):

High Risk ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

High Risk Population ◽

Risk Population ◽

Indium 111

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Upper extremity deep venous thrombosis: risk factors, diagnosis, treatment

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2016.1.5 ◽

2016 ◽

Vol 11 (1) ◽

pp. 28-32

Author(s):

Camelia C. DIACONU ◽

◽

Mădălina ILIE ◽

Mihaela Adela IANCU ◽

◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

High Risk ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Upper Extremity ◽

Brachiocephalic Vein ◽

Risk Of Death ◽

Thrombosis Risk ◽

Effort Thrombosis

Upper extremity deep venous thrombosis is a condition with increasing prevalence, with high risk of morbidity and mortality, due to embolic complications. In the majority of the cases, thrombosis involves more than one venous segment, most frequently being affected the subclavian vein, followed by internal jugular vein, brachiocephalic vein and basilic vein. Upper extremity deep venous thrombosis in patients without risk factors for thrombosis is called primary deep venous thrombosis and includes idiopathic thrombosis and effort thrombosis. Deep venous thrombosis of upper extremity is called secondary when there are known risk factors and it is encountered mainly in older patients, with many comorbidities. The positive diagnosis is established only after paraclinical and imaging investigations, ultrasonography being the most useful diagnostic method. The most important complication, with high risk of death, is pulmonary embolism. Treatment consists in anticoagulant therapy, for preventing thrombosis extension and pulmonary embolism.

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Prevalence and risk factors of preoperative deep venous thrombosis in closed patella fracture: a prospective cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02558-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zhanchao Tan ◽

Hongzhi Hu ◽

Zhongzheng Wang ◽

Yuchuan Wang ◽

Yingze Zhang

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Study Cohort ◽

Patella Fracture ◽

Total Hospital Stay ◽

Stay Time ◽

Independent Risk Factors ◽

Associated Risk Factors ◽

D Dimer

Abstract Background The preoperative prevalence of deep venous thromboembolism (DVT) of patella fracture is not well established. The study aimed to investigate the preoperative prevalence, the associated risk factors, and the locations of deep venous thrombosis (DVT) in patients with closed patella fracture. Methods Patients who sustained closed patella fracture between January 1, 2016, and April 1, 2019, were included. Blood analyses and ultrasonography of bilateral lower extremities were routinely performed. Data of demographics, comorbidities, mechanism of injury, fracture type, total hospital stay, time from injury to DVT, and laboratory indexes were prospectively collected and compared between groups with and with non-DVT. Multivariate logistic regression analyses were performed to determine the independent risk factors of DVT. Results Among the study cohort of 790 patients, 35 cases occurred in preoperative DVTs, indicating a prevalence of 4.4%, with 3.2% distal and 1.2% proximal DVT. Age ≥ 65 years old (OR, 3.0, 95% CI, 1.1–8.1), D-dimer > 0.5 mg/L (OR, 2.3, 95% CI, 1.1–4.8), and albumin < 35 g/L (OR, 2.5, 95% CI, 1.2–5.3) were identified to be risk factors of DVT in closed patella fracture. Among the DVTs, 30 cases (85.7%) occurred in the injured extremity, 3 cases (8.6%) in bilateral extremities, and 2 cases (5.7%) solely in the uninjured extremity. Conclusion The prevalence of preoperative DVT in closed patella fracture was 4.4%, with 3.2% for distal and 1.2% for proximal DVT. We recommend individualized risk stratification and early anticoagulation for patients with risk factors (age ≥ 65 years, D-dimer > 0.5 mg/L and albumin < 35g/L).

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Pulmonary embolism secondary to deep venous thrombosis: A retrospective and observational study for clinical characteristics and risk stratification

Phlebology The Journal of Venous Disease ◽

10.1177/0268355521990964 ◽

2021 ◽

pp. 026835552199096

Author(s):

Xiaoying Chen ◽

Xian Liu ◽

Jinglun Liu ◽

Dan Zhang

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Scoring System ◽

Previous History ◽

Previous Surgery ◽

Significant Difference ◽

Independent Risk Factors ◽

D Dimer

Objective To investigate the risk factors, predilection sites in pulmonary embolism (PE) patients caused by deep venous thrombosis (DVT) and explore the value of scoring systems in assessing the risk of PE in DVT patients. Methods A total of 692 DVT patients were enrolled, and divided into no pulmonary embolism (NPE, 226, 32.66%), silent pulmonary embolism (SPE, 330, 47.67%) and featuring pulmonary embolism (FPE, 136, 19.65%) groups. For each group, the differences of clinical data and PE locations were compared, and the risk factors of PE secondary to DVT were analyzed. The predictive value of the scoring system for the diagnosis of PE and FPE was evaluated. Results PE presented more in the bilateral pulmonary arteries (PAs) (249, 53.43%) and has no significant difference in PESI scores in different locations. Gender, DVT locations, and previous surgery were the independent risk factors of PE. DVT locations, previous history of COPD, and previous surgical interventions were the independent risk factors of FPE. The results for areas under the ROC curves were: AUC(Wells) = 0.675, AUC (Revised Geneva) = 0.601, AUC(D-dimer) = 0.595 in the PE group; AUC(Wells) = 0.722, AUC (Revised Geneva) = 0.643, AUC(D-dimer) = 0.557 in the FPE group. Conclusions PE secondary to DVT mostly occurs in the bilateral PAs. Male gender, DVT locations, and previous surgery increased the risk of PE. The Wells scoring system was more advantageous for evaluating the diagnosis of PE in patients with DVT.

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Thromboembolic complications during pregnancy and delivery

Medicinski pregled ◽

10.2298/mpns1310417s ◽

2013 ◽

Vol 66 (9-10) ◽

pp. 417-423 ◽

Cited By ~ 2

Author(s):

Radmila Sparic ◽

Biljana Lazovic ◽

Zoran Stajic ◽

Sanja Mazic ◽

Marina Djelic ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

High Risk ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Central Place ◽

Pulmonary Angiography ◽

Pregnancy And Delivery ◽

Pass Through ◽

In Pregnancy

Introduction. Venous thromboembolism is one of the leading cause of maternal mortality worldwide. The incidence of venous thromboembolism is estimated at 0.76 to 1.72 per 100.000 pregnancies which is four times as great as the risk in nonpregnant women. The purpose of this article is to raise awareness of this frequent problem in pregnancy and provide a practical approach for the diagnosis, management, and prevention of venous thromboembolism during pregnancy and delivery. Risk factors. A number of risk factors for the development venous thromboembolism have been identified. The two most important risk factors for venous thromboembolism in pregnancy are thrombophilia and previous venous thromboembolism. Deep venous thrombosis in the majority of cases occurs in the lower extremities and pelvis. Diagnosis. As the clinical diagnosis of venous thromboembolism is unreliable, the women who are suspected of having deep venous thrombosis or pulmonary embolism should be examined promptly using imaging diagnostics. The first diagnostic method is Doppler ultrasound. Where available, individual authors recommend magnetic resonance venography, pulmonary angiography or computed tomography. Therapy. Unfractionated heparin or low-molecularweight heparin has a central place in the prevention and treatment of venous thromboembolism in pregnancy because they do not pass through the placenta, thus avoiding the risks likely to be induced by warfarin. The prevention of venous thromboembolism must focus on the patients known to be at high risk bearing in mind that the recommendations for prophylaxis, even in high-risk patients, are based on the limited data.

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Early incidence of deep venous thrombosis and its risk factors after knee arthroscopic surgery in patients with anticoagulant and non-anticoagulant

10.21203/rs.3.rs-44143/v1 ◽

2020 ◽

Author(s):

Lei Shu ◽

Qubo Ni ◽

Biao Chen ◽

Hangyuan He ◽

Liaobin Chen ◽

...

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Color Doppler ◽

Multiple Logistic Regression Analysis ◽

Arthroscopic Surgery ◽

Anesthetic Technique ◽

Tourniquet Time ◽

Significant Difference ◽

D Dimer

Abstract Purpose: To investigated the early incidence of deep venous thrombosis (DVT) and its risk factors after knee arthroscopic surgery in patients with anticoagulant and non-anticoagulant.Methods: 272 patients were reviewed who have undergone knee arthroscopic surgery in our hospital from January 2018 to October 2019. Color doppler ultrasound was performed for every patient at 24h preoperatively and three days after operation. On the first day after surgery, low molecular weight heparin (LMWH) was randomly administered to some patients and not in others. The following factors were recorded: gender, age, body mass index (BMI), preoperative platelet and D-dimer level, D-dimer level three days after surgery, anesthetic technique, tourniquet time, whether to use LMWH after operation, and type of surgical procedures. Chi-square test or Student t test was used to preliminarily screen out suspected risk factors. Then, multiple logistic regression analysis was utilized to further determine the risk factors of DVT after knee arthroscopic surgery.Results: The incidence of DVT in the postoperative anticoagulant group was 7.5%, and 7.4% in the non-anticoagulant group. An increased incidence was found among higher D-dimer level postoperatively. There was no significant difference in the incidence of DVT between use of LMWH and non-use of LMWH in three days after surgery.Conclusion: The early incidence of DVT in the group of patients without LMWH was 7.4%. The incidence of DVT in patients with knee arthroscopy surgery could not be reduced by using LMWH within three days, and high D-dimer level was a risk factor for DVT after knee arthroscopic surgery.

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Deep Venous Thrombosis in COVID-19 Patients: A Cohort Analysis

10.21203/rs.3.rs-39414/v1 ◽

2020 ◽

Author(s):

Yi Guo ◽

Yun You ◽

Ke Hu ◽

Fei Cai ◽

Yiqing Li ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Sex Difference ◽

Anticoagulant Therapy ◽

Neutrophil Count ◽

Anticoagulation Therapy ◽

Multivariate Logistic Regression ◽

D Dimer

Abstract BackgroundDeep venous thrombosis (DVT) is a severe complication of the coronavirus disease 2019 (COVID-19). It may interfere with COVID-19 treatment and delay the recovery, but there is less data about the anticoagulant therapy and sex difference of VTE in patients with COVID-19. The purpose of this study is to study the prevalence, risk factors, anticoagulant therapy and sex difference of deep venous thrombosis (DVT) in patients with COVID-19.MethodsThe enrolled 121 patients were confirmed positive for COVID-19. All suspected patients with a high Caprini index (≥4) or PADUA index (≥4) received color Doppler Ultrasound (US) to screen DVT in both lower extremities. Clinical characteristics of DVT-COVID-19 patients were analyzed. Multivariate logistic regression was performed to identify risk factors related to DVT in COVID-19 patients. The distribution of DVT locations, anticoagulation therapy with sex difference, and the outcomes were also analyzed.ResultsDVT was found in 48% asymptomatic COVID-19 patients with increased PAUDA index or Caprini index by US scanning. Multivariate logistic regression determined that age, CRP and baseline D-dimer were risk factors among COVDI-19 patients. Although the most common DVT location was infrapopliteal (Class I and Class II), higher mortality in DVT-COVID-19 patients was confirmed. DVT-COVID-19 patients presented significant increases in the CRP, neutrophil count and D-dimer throughout the whole inpatient period compared to non-DVT-COVID-19 patients. Although anticoagulation therapy accelerated the recovery of lymphocytopenia condition in DVT patients, men DVT-COVID-19 patients showed higher CRP and neutrophil count vs. lymphocyte count (N/L) ratio but lower lymphocyte count compared to women DVT-COVID-19 patients. ConclusionsDVT is common in COVID-19 patients with high risk factors, especially for older age, higher CRP and baseline D-dimer populations. It is important to consider sex differences in the anticoagulant therapy among DVT-COVID-19 patients.

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Early incidence of deep venous thrombosis and its early marker after knee arthroscopy: A retrospective study with routinely applied ultrasonography

10.21203/rs.3.rs-44143/v2 ◽

2020 ◽

Author(s):

Lei Shu ◽

Qubo Ni ◽

Biao Chen ◽

Hangyuan He ◽

Liaobin Chen ◽

...

Keyword(s):

Risk Factors ◽

Molecular Weight ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Low Molecular Weight Heparin ◽

Knee Arthroscopy ◽

Multiple Logistic Regression Analysis ◽

Low Molecular Weight ◽

Early Marker ◽

D Dimer

Abstract Background: To (1) investigate the early incidence of deep venous thrombosis (DVT) after knee arthroscopy at a single institution and (2) determine the early marker for DVT in these patients.Methods: The records of patients who underwent knee arthroscopy in our department between January 2018 and October 2019 were reviewed. Ultrasonography was performed for each patient at 24h preoperative and 72h postoperative. The low-molecular-weight-heparin (LMWH) was routinely used as thromboprophylaxis on the first day postoperative after 1st January 2019. Preoperative and perioperative data were collected with respect to demographic data, medical history, medications, and surgical and anesthesia data. Chi-square test or Student t test was used to preliminarily screen out suspected risk factors. Then, multiple logistic regression analysis was utilized to further determine the risk factors of DVT after knee arthroscopy.Results: During the study period, 272 patients were reviewed. Among these patients, 21 cases of DVT occurred, resulting in an incidence of 7.7%, two (0.74%) of which were identified as symptomatic thrombosis. The incidence of DVT in the anticoagulant group was 7.9%, and 7.4% in the non-anticoagulant group, respectively. The use of low molecular weight heparin postoperative did not reduce the incidence of DVT after knee arthroscopy. An increased D-dimer level could be an early marker for an elevated risk of postoperative DVT. No association between different arthroscopic procedures and thrombotic events. And the tourniquet time are not related risk factor.Conclusions: In this study, the early incidence of DVT after knee arthroscopy was 7.7%. Symptomatic DVT was rare and occurred infrequently. The incidence of DVT within three days could not be reduced by using LMWH, and a high D-dimer level was an early marker for DVT after knee arthroscopy.

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