scholarly journals Clinical Predictors for Deep Vein Thrombosis on Admission in Patients with Intertrochanteric Fractures: A Retrospective Study

2020 ◽  
Author(s):  
Jixing Fan ◽  
Fang Zhou ◽  
Xiangyu Xu ◽  
Zhishan Zhang ◽  
Yun Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Varicose Veins ◽  
High Energy ◽  
Intertrochanteric Fractures ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Time From Injury

Abstract Background Limited studies are available to investigate the prevalence of preoperative deep vein thrombosis (DVT) in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures.Methods This retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients’ clinical data were collected. Cumulative incidence plots were calculated to assess the overall DVT risk and the median time from injury to admission. A stepwise multiple logistic regression analysis was used to identify the risk factors contributing to the occurrence of DVT.Results The overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P<0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, atrial fibrillation, varicose veins and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT.Conclusions A high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, routine DVT screening before admission was necessary for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.

scholarly journals Clinical predictors for deep vein thrombosis on admission in patients with intertrochanteric fractures: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jixing Fan ◽  
Fang Zhou ◽  
Xiangyu Xu ◽  
Zhishan Zhang ◽  
Yun Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Univariate Analysis ◽  
High Energy ◽  
Intertrochanteric Fractures ◽  
Multivariate Logistic Regression ◽  
Vein Thrombosis ◽  
High Prevalence ◽  
Deep Vein ◽  
Time From Injury

Abstract Background Limited studies were available to investigate the prevalence of deep vein thrombosis (DVT) on admission in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures. Methods This retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients’ clinical data were collected. Univariate analysis and stepwise backward multivariate logistic regression were used to identify the risk factors contributing to the occurrence of DVT. Results The overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). The mean time from injury to admission was 2.1 days in the total population, 2.96 and 1.87 days in patients with and without DVT. Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, lower Hb value, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P < 0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, lower Hb, diabetes and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT. Conclusions A high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, surgeons should be aware of the high prevalence of DVT for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.

ACQUIRED RISK FACTORS AND DEEP VEIN THROMBOSIS IN SYMPTOMATIC OUT PATIENTS

1987 ◽  
Author(s):  
P Prandoni ◽  
A W A Lensing ◽  
G Zambon ◽  
A Breda ◽  
S Cuppini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
Heart Disease ◽  
Deep Vein Thrombosis ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Varicose Veins ◽  
Estrogen Therapy ◽  
Vein Thrombosis ◽  
Deep Vein

Previous studies revealed a number of acquired risk factors predisposing to acute deep vein-thrombosis (DVT). Unfortunately many of these clinical or epidemiologic studies were not proper designed, since they didn't include consecutive patients, used no or different types of objective endpoints or collected the data retrospectively. In a prospective trial we evaluated 307 consecutive out-patients with clinically suspected DVT by using ascending venography, which confirmed suspicion in 136 (44%). A history of prior thrombotic episodes as well as factors predisposing to DVT including advancing age, obesity, smoking habits, cancer, chronic lung and/or heart disease, immobilization, pregnancy, childbirth, chronic liver disease, systemic lupus erythematosus (SLE), nephrotic syndrome, varicose veins, fractures or trauma or chronic arteriopathies of the legs, diabetes mellitus (DM), recent surgery and estrogen therapy were recorded in all patients. The results of our comparison of these risk factors with the outcome of venography indicate clearly a significant difference (chi-square test) between patients with and without DVT for the following: -previous documented thromboembolism, cancer (p < 0.01); -chronic lung and/or heart disease, age > 65 years, immobilization (p < 0.05). The frequency of pregnancy, childbirth, nephrotic syndrome and chronic liver disease among our patients was too low for providing sufficiently narrow confidence limits. Surprisingly the presence of varicose veins will decrease the possibility of DVT (p < 0.01). In all patients (n=3) affected by SLE clinical suspicion was confirmed. Obesity, smoking habits, recent trauma or fracture or chronic artheriopathies of the legs, DM, recent surgery and estrogen therapy were not associated with an increased risk of thrombosis, since their presence in both groups was approximately the same.

scholarly journals Profile of Patients with Isolated Distal Deep Vein Thrombosis versus Proximal Deep Vein Thrombosis or Pulmonary Embolism: RE-COVERY DVT/PE Study

2021 ◽  
Author(s):  
Sebastian Schellong ◽  
Walter Ageno ◽  
Ivan B. Casella ◽  
Kok Han Chee ◽  
Sam Schulman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Varicose Veins ◽  
Oral Anticoagulants ◽  
Patient Characteristics ◽  
Global Perspective ◽  
Vein Thrombosis ◽  
Distal Deep Vein Thrombosis ◽  
Deep Vein

AbstractIsolated distal deep vein thrombosis (IDDVT) is presumed to be more benign than proximal DVT (PDVT) or pulmonary embolism (PE), suggesting a need for different management approaches. This subgroup analysis of the RE-COVERY DVT/PE global, observational study investigated patient characteristics, hospitalization details, and anticoagulant therapy in patients with IDDVT in real-world settings in 34 countries enrolled from January 2016 to May 2017. Data were analyzed descriptively according to the type and location of the index venous thromboembolism (VTE): IDDVT, PDVT ± distal DVT (DDVT), and PE ± DVT. Of the 6,095 eligible patients, 323 with DVT located outside the lower limb and no PE were excluded. Of the remaining 5,772 patients, 17.6% had IDDVT, 39.9% had PDVT ± DDVT, and 42.5% had PE ± DVT. IDDVT patients were younger and had fewer risk factors for VTE than the other groups. Other comorbidities were less frequent in the IDDVT group, except for varicose veins, superficial thrombophlebitis, and venous insufficiency. IDDVT patients were less likely to be diagnosed in an emergency department (22.3 vs. 29.7% for PDVT ± DDVT and 45.4% for PE ± DVT) or hospitalized for VTE (29.2 vs. 48.5% for PDVT ± DDVT and 75.0% for PE ± DVT). At hospital discharge or 14 days after diagnosis (whichever was later), non–vitamin K antagonist oral anticoagulants were the most commonly used anticoagulants (55.6% for IDDVT, 54.7% for PDVT ± DDVT, and 52.8% for PE ± DVT). Although differences in patient characteristics, risk factors, and clinical management were identified, anticoagulant treatment of IDDVT was almost equal to that of PDVT or PE. Prospective studies should investigate whether, in a global perspective, this is an appropriate use of anticoagulants. Trial registration number ClinicalTrials.gov NCT02596230.

scholarly journals Risk Factors and Anticoagulation Therapy in Patients With Isolated Distal Deep Vein Thrombosis in the Early Post-operative Period After Thoracic Surgery

2021 ◽  
Vol 8 ◽  
Author(s):  
Yuping Li ◽  
Junrong Ding ◽  
Lei Shen ◽  
Jian Yang ◽  
Haifeng Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Deep Vein Thrombosis ◽  
Thoracic Surgery ◽  
Anticoagulation Therapy ◽  
Vein Thrombosis ◽  
Half Dose ◽  
Deep Vein ◽  
D Dimer

Background: Isolated distal deep vein thrombosis (IDDVT) accounts for ~50% of all patients diagnosed with deep venous thrombosis (DVT), but the diagnosis and optimal management of IDDVT remains unclear and controversial. The aim of this study was to explore potential risk factors and predictors of IDDVT, and to evaluate different strategies of anticoagulation therapy.Methods: A total of 310 consecutive patients after thoracic surgery, who underwent whole-leg ultrasonography as well as routine measurements of D-dimer levels before and after surgery were evaluated. The general clinical data, anticoagulant therapy, pre- and postoperative D-dimer levels were collected. Differences between IDDVT, DVT and non-DVT groups were calculated. Logistic regression analysis was used to analyze risk factors of postoperative IDDVT.Results: Age and postoperative D-dimer levels were significantly higher in IDDVT group than in non DVT group (p = 0.0053 and p &lt; 0.001, respectively). Logistic regression analysis showed that postoperative D-dimer level was a significant independent predictor of IDDVT even when adjusted for age and operation method (p = 0.0003). There were no significant side effects associated with both full-dose and half-dose anticoagulation regimens. Half-dose therapy was associated with a significant decrease in the requirement for anticoagulation medications after discharge (p = 0.0002).Conclusion: Age and D-dimer levels after surgery are strong predictors of IDDVT following thoracic surgery. Half-dose therapeutic anticoagulation has the same efficiency in preventing IDDVT progression, is not associated with any additional risks of adverse effects compared to a full-dose regimen, and may be adopted for treating IDDVT patients after thoracic surgery.

scholarly journals TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING VARICOSE VEINS AND ITS PREVENTION AMONG OT AND ICU STAFF NURSES

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Mr. Abhimanyu Sharma sharma ◽  
Dr. Rajendra Prasad Sharma sharma ◽  
Dr. Rajendra Prasad Sharma sharma
Keyword(s):  
Risk Factors ◽  
Varicose Veins ◽  
Staff Nurses ◽  
Venous Disease ◽  
Human Beings ◽  
Vein Wall ◽  
Teaching Programme ◽  
Prolonged Standing ◽  
Vein Thrombosis ◽  
Deep Vein

Many factors predispose human beings to a disease of the lower extremities, and this condition affects approximately eighty million Americans. Itsmanifestations may appear to be little more than a cosmetic nuisance, yet it may be an indication of a more serious underlying problem undetected by visual inspection. Venous disease is also capable of producing a plethora of uncomfortable symptoms, and left untreated, may progress to cutaneous pigmentation, dermatitis, ulceration, haemorrhage, or superficial thrombophlebitis. Although uncomplicated cases of the disease are more common, venous disease should not be taken lightly. Steps to retard disease expression and progression should be implemented whenever possible. As blood rushes through our legs the veins send it back to the heart. In case of prolonged standing, due to force of gravity the veins lose their ability to push the blood upwards, causing the blood to settle down in certain areas of the veins. Varicose veins are tortuous, distended and bulging vein s (varicosities) beneath the skin of the legs. They are most often swollen and gnarled veins that most frequently occur in the legs, ankles and feet. Even though the exact cause of varicose veins is unknown, there are some risk factors which contribute to development of this problem. Some of the risk factors are, low physical activity, smoking, family heredity of varicose veins, congenital valve or vein wall defects, valve damage from trauma, obstruction, deep vein thrombosis (DVT) or inflammation, chronic venous distention associated with occupations requiring prolonged standing, obesity or pregnancy, systemic conditions that interfere with venous return and loss of vein wall elasticity with ageing.

Permanent atrial fibrillation and pulmonary embolism in elderly patients without deep vein thrombosis: is there a relationship?

2018 ◽  
Vol 31 (8) ◽  
pp. 1121-1128 ◽  
Author(s):  
Pasquale Morella ◽  
Maurizio Sacco ◽  
Mariano Carafa ◽  
Gaetana Ferro ◽  
Francesco Curcio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Elderly Patients ◽  
Vein Thrombosis ◽  
Permanent Atrial Fibrillation ◽  
Deep Vein

scholarly journals Bilateral pulmonary embolism without deep venous thrombosis was observed after knee arthroscopy: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuan Li ◽  
You-Xia Chen ◽  
Xiang-Tian Deng ◽  
Shun-cheng Yang ◽  
Zhi-Yuan Su ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Knee Arthroscopy ◽  
Varicose Veins ◽  
Perioperative Period ◽  
Medical Attention ◽  
Vein Thrombosis ◽  
Symptomatic Pulmonary Embolism ◽  
Deep Vein

Abstract Background Symptomatic pulmonary embolism (PE) after knee arthroscopy is extremely rare. If the embolism is not treated promptly, the patient may die. Bilateral pulmonary embolism with associated pulmonary infarct without concomitant deep vein thrombosis has never been reported following routine knee arthroscopy. Case presentation A 50-year-old female patient with no other risk factors other than hypertension, obesity, varicose veins in the ipsilateral lower extremities and elevated triglyceride (TG) presented to our ward. She had experienced sudden chest tightness, polypnea and fainting after going to the bathroom the morning of the second postoperative day and received emergency medical attention. Colour ultrasonography of the extremities showed no deep vein thrombosis. Lung computed tomography angiography (CTA) showed multiple embolisms scattered in both pulmonary artery branches. Thus, emergency interventional thrombolysis therapy was performed, followed by postoperative symptomatic treatment with drugs with thrombolytic, anticoagulant and protective activities. One week later, lung CTA showed a significant improvement in the PEs compared with those in the previous examination. Since the aetiology of PE and no obvious symptoms were discerned, the patient was discharged. Conclusion Although knee arthroscopy is a minimally invasive and quick procedure, the risk factors for PE in the perioperative period should be considered and fully evaluated to enhance PE detection. Moreover, a timely diagnosis and effective treatment are important measures to prevent and cure PE after knee arthroscopy. Finally, clear guidelines regarding VTE thromboprophylaxis following knee arthroscopy in patients with a low risk of VTE development are needed.

Predictive factors for concurrent deep-vein thrombosis and symptomatic venous thromboembolic recurrence in case of superficial venous thrombosis

2011 ◽  
Vol 105 (01) ◽  
pp. 31-39 ◽  
Author(s):  
Celine Genty ◽  
Marie-Antoinette Sevestre ◽  
Dominique Brisot ◽  
Michel Lausecker ◽  
Jean-Luc Gillet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Predictive Factors ◽  
Adverse Outcome ◽  
Varicose Veins ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Venous Thromboembolic ◽  
Deep Vein

SummarySuperficial venous thrombosis (SVT) prognosis is debated and its management is highly variable. It was the objective of this study to assess predictive risk factors for concurrent deep-vein thrombosis (DVT) at presentation and for three-month adverse outcome. Using data from the prospective multicentre OPTIMEV study, we analysed SVT predictive factors associated with concurrent DVT and three-month adverse outcome. Out of 788 SVT included, 227 (28.8%) exhibited a concurrent DVT at presentation. Age >75years (odds ratio [OR]=2.9 [1.5–5.9]), active cancer (OR=2.6 [1.3–5.2]), inpatient status (OR=2.3 [1.2–4.4]) and SVT on non-varicose veins (OR=1.8 [1.1–2.7]) were significantly and independently associated with an increased risk of concurrent DVT. 39.4% of SVT on non-varicose veins presented a concurrent DVT. However, varicose vein status did not influence the three-month prognosis as rates of death, symptomatic venous thromboembolic (VTE) recurrence and major bleeding were equivalent in both non-varicose and varicose SVTs (1.4% vs. 1.1%; 3.4% vs. 2.8%; 0.7% vs. 0.3%). Only male gender (OR=3.5 [1.1–11.3]) and inpatient status (OR=4.5 [1.3–15.3]) were independent predictive factors for symptomatic VTE recurrence but the number of events was low (n=15, 3.0%). Three-month numbers of deaths (n=6, 1.2%) and of major bleedings (n=2, 0.4%) were even lower, precluding any relevant interpretation. In conclusion, SVT on non-varicose veins and some classical risk factors for DVT were predictive factors for concurrent DVT at presentation. As SVT remains mostly a clinical diagnosis, these data may help selecting patients deserving an ultrasound examination or needing anticoagulation while waiting for diagnostic tests. Larger studies are needed to evaluate predictive factors for adverse outcome.

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