Prevalence, incidence, and risk factors for venous thromboembolism in medical-surgical intensive care unit patients

Abstract

An assessment of the incidence and prevalence of venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), in medicalsurgical intensive care unit (ICU) patients is based on 3 premises. First, although PE is the main thromboembolic outcome of interest, because it confers an increased risk of morbidity and mortality, no studies have systematically assessed the incidence or prevalence of this complication in ICU patients [1]. Consequently, DVT is used as a surrogate for PE risk in most studies of ICU patients. Second, the incidence of DVT in ICU patients is dependent on whether DVT is detected only in patients with symptoms suggestive of DVT or based on systematic screening of all patients, irrespective of symptoms. This issue is important because 10% to 100% of DVT in ICU patients can be clinically silent [2-4]. Third, the incidence of DVT depends on the screening methods used [5,6]. Lower-limb compression ultrasound, which is a commonly used screening method, detects larger proximal DVT and would underestimate the incidence of any DVT (proximal or distal) detected by ascending venography, the diagnostic reference standard test