Clinical profile, risk factors, and clinical outcomes in patients of venous thromboembolism at a tertiary care center.

Abstract

Venous thromboembolism (VTE) commonly presents as either deep-vein thrombosis (DVT) or pulmonary embolism (PE). Despite rapid advances in its diagnostic and therapeutic modalities, it still leads to significant morbidity and mortality. Our study predominantly aims at studying the clinical profile, risk factors, and the clinical outcomes in VTE patients presenting to a single tertiary care center to rapidly detect the disease and use appropriate thrombo-prophylaxis. This was an prospective observational study involving 40 patients of confirmed cases of VTE who presented to this tertiary care hospital during a period from June 2017 to May 2019. Data collected included the age, sex, clinical presentation, risk factors, diagnostic modalities, and their clinical outcomes. Descriptive analysis was carried out by mean and standard deviation for quantitative variables; frequency and proportion for the categorical variables. Among the study groups, 30 (74%) had DVT, 4 (11%) had PE, and 6 (15%) had both. Major risk factors detected included smoking history (44%), recent surgery (15%), malignancy (11%), history of immobility (10%), and past history of DVT (15%). The clinical presentation mainly included leg pain (62%) and leg swelling (87%).The outcomes were predominantly re-canalization (31%), recurrent DVT (21%), recurrent PE (1%), chronic DVT (27%), chronic venous insufficiency (36%), chronic venous ulcer (7%), pulmonary hypertension (16%), and death (5%). In our study population, the most common pro-thrombotic state was found to be hyperhomocysteinemia. In our study of VTE patients, we have highlighted the possible risk factors, clinical presentation, and clinical outcomes to identify the disease early and help us initiate appropriate thromboprophylaxis to reduce morbidity.