Fibroids as a Risk Factor for Deep Vein Thrombosis (DVT) at an Urban Academic Institution: A Retrospective Observational Study

Abstract

<h3>Study Objective</h3> To assess if and how fibroids increase the risk of developing a DVT, and review how these patients have been managed. <h3>Design</h3> This retrospective observational study reviews the characteristics of fibroids in patients who have been diagnosed with a DVT. <h3>Setting</h3> Urban academic tertiary-care hospital, single institution. <h3>Patients or Participants</h3> Women ages 18 to 65 years old with a diagnosis of a fibroid uterus who had a thrombotic event from January 1, 2012, to December 31, 2019, were reviewed. ICD-10 codes were used to obtain charts of a total of 1293 patients. Of these, 221 met inclusion criteria and 73 underwent full chart review. Their average BMI was 34.5 and average hemoglobin was 10.2. <h3>Interventions</h3> A retrospective observational chart review was completed to assess how patients with a fibroid uterus who had a thrombotic event were managed and the characteristics of these fibroid uteri. <h3>Measurements and Main Results</h3> 100% of the patients (n=73) were diagnosed with a fibroid uterus and lower extremity DVT and/or pulmonary embolism (PE). 66% (n=48) of these thrombotic events were unprovoked. Of those that were provoked, 32% (n=8) were postoperative after a hysterectomy for symptomatic uterine fibroids. Of those patients diagnosed with a thrombotic event subsequently needing surgery for their fibroids, only 24% (n=4) were able to complete their surgery within the first 3 months of the thrombotic event. Characteristics of fibroids in patients with a thrombotic event were as follows: the mean size of the largest fibroid was 6.3cm; the mean uterine volume was 575cc with 64% of the uteri ranging from 100-700cc; 80% had 5 or fewer fibroids with 16% only having one fibroid. <h3>Conclusion</h3> Fibroid uteri may be an independent risk factor for developing a DVT in women ages 18 to 65 years old. These patients should be risk-stratified and appropriate chemoprophylaxis should be considered in an attempt to prevent thrombotic events.