AB1448 DEEP VENOUS THROMBOSIS IN YOUNG ADULTS: INCIDENCE AND RISK FACTORS

Abstract

BackgroundAfter a first venous thromboembolic (VTE) episode, recurrence is frequent and associated with significant morbidity and mortality.ObjectivesOur aim is to identify the risk factors for recurrent VTE in young subjects and to assess the risk-benefit ratio of continuing long-term anticoagulant treatment.MethodsWe carried out a retrospective study including 100 patients with deep vein thrombosis (DVT) admitted to the Internal Medicine Department at Fattouma Bourguiba University Hospital in Monastir between 2011 and 2020.ResultsIn our study, the gender ratio was 1.17. The mean age was 34.49 years ± 9.19. Lower extremity deep venous thrombosis (LEDVT) was the most common location (90%). Pulmonary embolism (PE) was found in 8% of cases. The most frequent risk factors were obesity: BMI>30 (40%), bed rest (20%), personal history of DVT (18%), smoking (16%), recent surgery dating less than one month (14%), and recent trauma (12%). The etiological assessment had concluded to inherited thrombophilia in 41 cases: protein S deficiency (23%), protein C deficiency (8%), activated protein C resistance (8%), and antithrombin III deficiency (2%); acquired thrombophilia in 28 cases: hyperhomocysteinemia (HH) in 19 cases and antiphospholipid syndrome (APLS) in 9 cases; Behçet’s disease in 10 cases and systemic lupus erythematosus in 5 cases. No cases of neoplasia were detected. The treatment was based on low molecular weight heparin (LMWH), relayed by vitamin k antagonists (VKAs), and physical therapy (graduated compression stockings and early mobilization). Duration of the treatment of DVT in the young adult depends on the nature and extent of the thrombosis, the underlying risk factors, and etiologies. Among the 100 hospitalized patients, recurrent DVT was detected in 20% of cases: 17% of patients reported a history of DVT with a mean number of previous episodes of 2, and only 3% developed DVT during their follow-up. The mean time to recurrence was three years. Recurrence was located on the same side in most cases (70%). In our study, only Behçet’s disease was associated with an increased risk of DVT recurrence (p: 0.015, OR: 5.46, CI [1.38-21.56]). Gender, age, venous insufficiency, and bed rest had no significant influence on the risk of recurrence (p>0.05).ConclusionYoung adults should be assessed for acquired and also genetic factors, which would suggest extending the duration of anticoagulant therapy in high-risk patients, reducing the incidence of post-thrombotic syndrome and VTE recurrence. Further studies are needed to evaluate the association of Behçet’s disease with DVT recurrence.Disclosure of InterestsNone declared