VENOUS THROMBOSIS IN THE MEDICAL UNIT- WHAT IS DIFFERENT?
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 39
Abstract
BACKGROUND Deep venous thrombosis is an important comorbidity in admitted patients with a reported incidence of up to 17.46 cases per 100000 patients. Though seen typically as a surgical complication, it is often encountered in the medically ill. MATERIALS AND METHODS A prospective observational study was carried out in a tertiary care centre. Patients admitted in the medical ward without any surgical illness or comorbidity were screened using the Well’s clinical criteria. Development of venous thrombosis was confirmed using Doppler ultrasound and CT pulmonary angiography. Statistical analysis was carried out using descriptive statistics at a confidence level of 95% with a p value of less than 0.05 considered significant. RESULTS Median age at presentation was 48 years with a male to female ratio of 1.5:1. Prevalence of deep venous thrombosis was 29.4% and that of pulmonary thromboembolism 3.92%. A high probability of venous thrombosis predicted by the Well’s scoring system was associated with subsequent development of deep venous thrombosis and pulmonary embolism. 17 out of 74 asymptomatic patients were found to have venous thrombosis which was statistically significant. 4 patients had proximal DVT, 10 had distal and 16 had both proximal and distal involvement. Duration of immobilisation was found to be the most important risk factor with a median duration of 12 days in those who developed venous thrombosis. Right ventricular hypokinesia on 2D Echo and CT pulmonary angiography were found to be diagnostic for venous thrombosis. 4 out of 30 patients of DVT and 1 out of 4 patients of pulmonary thromboembolism died. CONCLUSION Deep venous thrombosis has a high prevalence in the medical ward. The Well’s clinical criteria is a good tool to predict deep venous thrombosis and pulmonary thromboembolism. Multiple acute medical conditions predispose to the development of venous thrombosis with prolonged immobilisation being the most important independent risk factor. Development of venous thrombosis during admission is associated with a poor outcome.
Authors and Affiliations
Vidya Sanjay Nagar, Rahul Kadu, Mayur Hedau, Basavaraj Sajjan, Rudrarpan Chatterjee
Keywords
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- EP ID EP213049
- DOI 10.14260/Jemds/2017/674
- Views 85
- Downloads 0
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