Factors Of Deep Vein Thrombosis Research Articles

An Analysis of Risk Factors for Deep Vein Thrombosis in the Lower Limbs and Nursing Strategies

This study aimed to analyze risk factors for deep vein thrombosis (DVT) in the lower limbs among inpatients and to discuss appropriate nursing measures. Clinical data from 32 DVT patients were analyzed retrospectively to identify the potential risk factors. Except for one case who was transferred to another hospital for surgical treatment, all 31 cases received conservative therapy via medication. With the Autar DVT scale applied, 10 cases scored below 10; 11 cases 11-14, and 11 cases 15 or above 15. The preliminary risk factors for DVT included advanced age, concurrent high-risk illnesses, lying in bed, obesity, trauma and surgical intervention. Among these 32 cases, the commonly noted concurrent illnesses were hypertension, coronary heart disease, diabetes, atrial fibrillation, infection and cerebral infarction. Twenty-five cases were combined with three or more concurrent illnesses (78.1%). Considering the risk factor scores for DVT and increasing the level of knowledge about DVT among nursing staff are crucial points in improving the quality of nursing practices. Extended nursing is a significant factor in reducing the risk of DVT among those lying in bed for long periods.

Absent inferior venacava and anti phospholipid antibody syndrome: Compounding risk factor for deep vein thrombosis and recurrent pregnancy loss

The spectrum of congenital anomalies of the inferior vena cava (IVC) has been well described in the literature, but the absence of IVC is a rare occurrence. Most of these patients remain asymptomatic, and the age of presentation depends on the development of deep-venous thrombosis. A young female presented to us with irregular bleeding per vaginum and recurrent pregnancy loss. A thorough general examination of the female patient revealed dilated veins over the abdomen and lower limbs. Investigations of recurrent pregnancy loss led to the diagnosis of antiphospholipid antibody syndrome and computed tomography venography to find out the cause of dilated veins lead to the diagnosis of absent IVC. Both these factors, i.e., absent IVC and the presence of autoimmune antibodies, have compounded the risk factor of thrombosis and management challenging which is discussed.

Targeted sequencing to identify novel genetic risk factors for deep vein thrombosis: a study of 734 genes

Summary.Background:Although several genetic risk factors for deep vein thrombosis (DVT) are known, almost all related to hemostasis, a large genetic component remains unexplained.Objectives:To identify novel genetic determinants by using targeted DNA sequencing.Patients/Methods:We included 899 DVT patients and 599 controls from three case–control studies (DVT-Milan, Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis [MEGA], and the Thrombophilia, Hypercoagulability and Environmental Risks in Venous Thromboembolism [THE-VTE] study) for sequencing of the coding regions of 734 genes involved in hemostasis or related pathways. We performed single-variant association tests for common variants (minor allele frequency [MAF] ≥ 1%) and gene-based tests for rare variants (MAF ≤ 1%), accounting for multiple testing by use of the false discovery rate (FDR).Results:Sixty-two of 3617 common variants were associated with DVT risk (FDR < 0.10). Most of these mapped to F5, ABO, FGA-FGG, and CYP4V2–KLKB1–F11. The lead variant at F5 was rs6672595 (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.29–1.92), in moderate linkage with the known variant rs4524. Reciprocal conditional analyses suggested that intronic variation might drive this association. We also observed a secondary association at the F11 region: missense KLKB1 variant rs3733402 remained associated conditional on known variants rs2039614 and rs2289252 (OR 1.36, 95% CI 1.101.69). Two novel variant associations were observed, in CBS and MASP1, but these were not replicated in the meta-analysis data from the International Network against Thrombosis (INVENT) consortium. There was no support for a burden of rare variants contributing to DVT risk (FDR > 0.2).Conclusions:We confirmed associations between DVT and common variants in F5, ABO, FGA–FGG, and CYP4V2–KLKB1–F11, and observed secondary signals in F5 and CYP4V2–KLKB1–F11 that warrant replication and fine-mapping in larger studies.

Incidence and risk factors for deep vein thrombosis among pediatric burn patients

BackgroundPatients with major burns covering a large total body surface area (%TBSA) fulfill all the criteria of Virchow’s triad, as a sequela of their injury. This places these patients at increased risk for developing deep vein thrombosis (DVT). However, data regarding the incidence of DVT in burn patients are minimal, especially in the pediatric age group. Therefore, the aim of this study is to determine the incidence of DVT in pediatric burn patients, identify possible risk factors for developing DVT, and explore the need for prophylactic treatment. MethodsA retrospective chart review of 95 patients admitted to our Burn Unit was conducted. We included all pediatric patients with second- and third-degree burns admitted to the unit. Exclusion criteria were adult patients, those with first-degree burns and admitted to the unit for <72h, patients discharged against medical advice, those admitted for elective reconstructive surgery, secondary admissions for non-healing/infected burns, and patients with trauma-induced skin loss. A data collection sheet was utilized. ResultsThe total incidence of thrombosis in our population was 4.2% (DVT, 3.1%; arterial thrombosis, 1.1%). Factors significantly associated with DVT included length of hospitalization (p=0.012), central venous catheter placement (p=0.013), and %TBSA (p=0.004). Unlike adult patients, weight for age (percentile) and body mass index were not significant risk factors for DVT in our patients. ConclusionBurns are a major risk factor for DVT, especially when covering large surface areas (≥40% TBSA) and combined with other factors (i.e., prolonged hospitalization and central lines). Thus, investigations for DVT and prophylactic anticoagulation should be considered for pediatric burn patients with these risk factors, even if they are asymptomatic.

Role of Nutritional Supplementation with Vitamin B12 and Folic Acid on Serum Homocysteine Levels of Deep Vein Thrombosis

Deep vein thrombosis is a common vascular disorder and association of Homocysteine with DVT is known. Evidence of decrease B12 and folic acid levels in DVT with Hyperhomocysteinemia has also been reported. Scanty data is available regarding role of folate and vitamin B12 on Homocysteine levels in DVT patients. The present study was undertaken in 100 patients. Study group comprised of 50 patients who had clinical features suggestive of DVT and 50 patients, who did not have clinical features suggestive of any venous or arterial disorder, were labelled as control group. All the patients of study group were given vitamin B12 and folic acid treatment along with standard treatment of DVT. Serum Homocysteine, folate, vitamin B12 were measured in all the patients in both the groups and estimated by chemiluminescence technology. After 12 weeks of vitamin B12 and folic acid therapy, serum Homocysteine levels, folic acid levels and vitamin B12 levels of study group were again estimated. The collected records and data was analysed statistically by Student t-test and Chi-square test. Mean Homocysteine level in study group was significantly higher as compared to control group (19.63 ± 19.14 µmol/mL vs. 7.0 ± 4.94 µmol/mL). Mean Homocysteine levels before treatment were 19.63 ± 19.14 µmol/mL and after treatment they were significantly reduced. Hyperhomocysteinemia is a risk factor for deep vein thrombosis. Folic acid and B12 therapy reduced the level of Homocysteine suggesting that this may decrease the chances of recurrence of DVT.

Венозний тромбоемболізм у травмованих із тяжкою поєднаною травмою живота

Introduction. According to the modern data, in the structure of peacetime injuries, the part of severe combined abdominal trauma (SCAT) occupies 5-20%, leading to disability in 25.2% of cases. Venous thromboembolism is a frequent complication of SCAT. Despite of progress in diagnostics, treatment and prevention, number of randomized multicenter studies on venous thromboembolism in the injured is insufficient, world standards and prevention recommendations remain sometimes controversial.The aim of the study. To improve the outcomes of the treatment of patients with SCAT by differentiated prophylaxis of venous thromboembolism.Materials and methods. One hundred and five patients with SCAT (ISS score result 16-35 (18.4±7.4) points), who underwent inpatient treatment at the Lviv city emergency clinical hospital, were comprehensively examined. Twenty-seven (25.7%) had deep vein thrombosis, which were operated for SCAT in 2012-2016.Results and discussion. Twenty-seven (25.7%) cases of thrombosis were verified in the basin of the lower vena cava, 10 (37.0%) of which were manifested clinically, namely by limb edema, pastosity and pain. The remaining (17-63%) cases were asymptomatic and were verified by ultrasonic compression angioscanning of the veins of the lower extremities. Thrombosis of tibial veins and the sural sinuses was asymptomatic and was verified in 7 (25.9%) cases, thrombosis of the popliteal vein was seen in 4 (14.8%), of superficial femoral vein in 5 (18.5%) and the common femoral vein was diagnosed in 8 (29.6%) patients. The cause of thrombosis of deep veins in the injured with SCAT is a combination of factors in preoperative (age over 50, time from injury to hospitalization for more than 6 hours, body mass index over 28, history of venous thrombosis and embolism) and postoperative (duration of operation over 160 minutes, ISS score result over 21 points, postoperative immobilization over 48 hours) periods, vascular damage, massive blood loss, use of hemostatic drugs, traumatic shock.Conclusions. In the absence of prevention, the incidence of deep vein thrombosis in patients with SCAT reaches 25.7%. The method of ultrasonic compression angioscanning of the veins of the lower extremities had revealed a predominance of the proximal nature of thrombosis; risk of fragmentation and potential thromboembolism of the pulmonary artery were detected in 13.7% of the injured. There are 18 significant (p&lt;0,05) parameters associated with the development of postoperative venous thrombosis and embolism in patients with SCAT, of which 4 are independent risk factors of deep vein thrombosis in the preoperative period (age over 50, time from injury to hospitalization over 6 hours, body mass index over 28, history of venous thrombosis and embolism) and 3 in the postoperative period (duration of operation over 160 minutes, ISS score result over 21 points, postoperative immobilization over 48 hours).

The current status and influencing factors of postoperative deep vein thrombosis in patients with acute spinal cord injury

Objective To explore the current status and influencing factors of deep vein thrombosis (DVT) in patients with acute spinal cord injury (ASCI) . Methods Totally 147 ASCI patients admitted in West China Hospital, Sichuan University between December 2015 and May 2016 were selected and investigated with the DVT incidence and relevant factor questionnaire for ASCI patients. Results Totally 14 patients out of the 147 patients sustained thrombosis, accounting for 9.5%. The Logistic regression analysis showed that patients' blood type, history of thrombosis and concurrent paraplegia were the main factors that influenced the incidence of vein thrombosis (P<0.05) . Conclusions ASCI patients are at high risk of vein thrombosis. Therefore, we need to make greater efforts to prevent and control thrombosis in ASCI patients whose blood type is not O and who have the history of thrombosis and paraplegia. Key words: Spinal cord injury; Vein thrombosis; Influencing factor

Risk factors for deep vein thrombosis of lower extremities in Sudanese women.

AimIn this study, we aimed to analyze the genetic and acquired risk factors for deep vein thrombosis (DVT) of the lower extremities among Sudanese women.MethodsA total of 136 women were enrolled in the study, including 75 DVT patients and 61 healthy controls. Demographic and clinical data were collected using a specific questionnaire. Citrated blood samples of patients and controls were used for coagulation assays, and DNAs isolated from EDTA-blood samples were used for the detection of Factor V Leiden and prothrombin G20210A mutations using multiplex polymerase chain reaction-restriction fragment length polymorphism analysis.ResultsBoth gene mutations were found to be absent from all 136 subjects, and therefore did not account for the incidence of DVT in Sudanese women. Of the 75 DVTs, 70 (93.3%) were localized in the left leg and 5 (6.7%) in the right leg. Additionally, 84% of the DVTs were proximal and 16% were distal. Among the 75 patients, 22 (29.33%) were postpartum, 7 (9.33%) were pregnant, and 46 (61.33%) were nonpregnant. Levels of prothrombin fragment 1+2, prothrombin time, activated partial thromboplastin time, and D-dimer were significantly higher in DVT patients than in healthy controls (P<0.0001).ConclusionRisk factors that most significantly affected patients in the 18–45 years age group were pregnancy and oral contraceptive usage, whereas those that most significantly affected patients in the 66–90 years age group were immobility, heart disease, and history of DVT.

High preoperative serum leptin level is an independent risk factor for deep vein thrombosis after total knee arthroplasty in osteoarthritis patients: A prospective and cross-sectional study.

It suggests that a high leptin level may increase the risk of venous thromboembolism (VTE) in animal studies. However, clinical studies in this field are still largely unexplored. Our objective was to evaluate the relationship between the preoperative serum leptin levels and postoperative VTE incidence in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) at our institute.We conducted a prospective and cross-sectional study in these OA patients from March 2014 to March 2016. Preoperative leptin levels were analyzed by Luminex assays. VTE was assessed preoperatively and on postoperative day 5 and 7. The potential risk factors for VTE were also documented.We enrolled 203 OA patients. No PE was detected and DVT was diagnosed in 34 patients postoperatively. There were significant differences between the median leptin levels in DVT group and non-DVT group [25.13 ng/mL (interquartile range, 14.51–44.31) vs 18.71 ng/mL (8.26–28.99), P = .007]. The relative risk of DVT significantly increased with natural logarithm (ln) leptin (per SD increase) (OR 2.37, 95% confidence interval (95% CI), 1.29–4.33, P = .005). Multivariate analyses adjusted for potential confounders showed ln leptin (per SD increase) was significantly associated with the relative risk of DVT (OR 2.17, 95% CI, 1.01–4.64, P = .046). When patients were subdivided into tertiles according to their leptin values, the OR for DVT increased with increasing tertiles of serum leptin (OR 1.03, 95% CI, 1.01–1.06, P for trend = .023).In the present study, our results indicate that a high preoperative leptin level may be an independent risk factor for postoperative DVT.

Plasminogen activator inhibitor-1: a risk factor for deep vein thrombosis after total hip arthroplasty

BackgroundThe onset of deep vein thrombosis (DVT) in patients after total hip arthroplasty (THA) may expand or enlarge and subsequently lead to significant mortality. The objective of this study was to investigate potential risk factors for DVT in patients after THA.MethodsEligible patients with hip joint diseases who were scheduled for unilateral primary THA at our hospital were prospectively included into this study. The demographic and clinical features, preoperative plasma biomarkers were detailed, recorded, and compared. The multiple logistic regression analysis was used to evaluate potential risk factors for DVT.ResultsA total of 214 subjects were enrolled into our study cohort for the final analysis, and 23 of them have suffered DVT with an incidence of 9.5%. The performance of logistic regression analysis showed that preoperative expression of plasminogen activator inhibitor-1 (PAI-1) was an independent risk factor for the onset of DVT in patients after THA (OR 1.18, 95% CI 1.04–1.29; p = 0.011).ConclusionsOur study indicated preoperative plasma PAI-1 expression as an independent risk factor for DVT in patients who underwent THA.

Deep vein thrombosis prophylaxis: Are we overdoing? An Asian survey on trends in bariatric surgery with a systematic review of literature.

Background:Obesity is a risk factor for deep vein thrombosis (DVT) and venous thromboembolism (VTE). VTE is the most common cause of mortality in patients undergoing bariatric surgery. There is considerable variation in practice regarding methods, dosages and duration of prophylaxis in this patient population. Most of the literature is based on Western patients and specific guidelines for Asians do not exist.Methods:We conducted a web-based survey amongst 11 surgeons from high-volume centres in Asia regarding their DVT prophylaxis measures in patients undergoing bariatric surgery. We collected and analysed the data.Results:The reported incidence of DVT and VTE ranged from 0% to 0.2%. Most surgeons (63.64%) preferred to use both mechanical and chemoprophylaxis with low-molecular-weight heparin being the most preferred form of chemoprophylaxis (81.82%). There was an equal distribution of weight-based, body mass index-based and fixed-dose regimens. Duration of chemoprophylaxis ranged from 3–5 days after surgery to 2 weeks after surgery. For high-risk patients, 60% surgeons preferred to start chemoprophylaxis at least 1 week before surgery. Routine use of inferior vena cava filters in high-risk patients was not preferred with some surgeons adopting a selective use (36.36%).Conclusion:The purpose of this survey was to understand the trends in DVT prophylaxis amongst different high-volume bariatric centres in Asia and to relate the same with the existing literature on the different steps in prophylaxis. There is, however, a need for consensus guidelines for DVT prophylaxis in Asian obese.

Evaluation of Genetic and Environmental Risk Factors for Deep Vein Thrombosis in Sudanese

Evaluation of Genetic and Environmental Risk Factors for Deep Vein Thrombosis in Sudanese

Causative factors of deep vein thrombosis of lower limb in Indian population

Background: Deep vein thrombosis refers to the formation of an abnormal coagulum within the deep venous system. An accurate diagnosis of DVT is extremely important to prevent potentially fatal acute complications of pulmonary embolism (PE) and long-term complications of post phlebitis syndrome and pulmonary hypertension. There are many causative factors for DVT.Methods: This was a prospective study where 50 cases of DVT were admitted in this centre. Patients were evaluated in terms of causative factors of DVT. These were previous history of DVT, immobility, surgery, smoking, obesity and drugs. Age and gender comparisons were also done. The most common causes were recorded.Results: The most common cause was found to be immobility and post-surgery immobilization which constituted 90 % of the patients in the study. Advanced age and male gender showed a higher incidence of DVT.Conclusions: Early identification of the causes and the risk factors in the development of DVT can reduce the burden of the disease and contribute to its prevention and management.

Detection of Deep Vein Thrombosis by Follow-up Indirect Computed Tomography Venography after Pulmonary Embolism

BackgroundInformation regarding the incidence and risk factors for deep vein thrombosis (DVT) detected by follow-up computed tomographic (CT) venography after pulmonary embolism (PE) is sparse. The aim of the present study was to identify the predictors of DVT in follow-up CT images, and to elucidate their clinical significance.MethodsPatients with PE were classified into the following three cohorts based on the time of indirect CT venography follow-up: within 1 month, 1 to 3 months, and 3 to 9 months after the initial CT scan. Each cohort was subdivided into patients with or without DVT detected by follow-up CT. Clinical variables were compared between the two groups.ResultsFollow-up CT revealed DVT in 61% of patients with PE within 1 month, in 15% of patients with PE at 1 to 3 months, and in 9% of patients with PE at 3 to 9 months after the initial CT scan. Right ventricular (RV) dilation on the initial CT (odds ratio [OR], 8.30; 95% confidence interval [CI], 1.89–36.40; p=0.005) and proximal DVT at the initial presentation (OR, 6.93; 95% CI, 1.90–25.20; p=0.003) were found to independently predict DVT in follow-up CT images within 1 month, proximal DVT at the initial presentation was found to independently predict DVT in follow-up CT images at 1 to 3 months (OR, 6.69; 95% CI, 1.53–29.23; p=0.012), and central PE was found to independently predict DVT in follow-up CT images at 3 to 9 months (OR, 4.25; 95% CI, 1.22–4.83; p=0.023) after the initial CT scan. Furthermore, the detection of DVT by follow-up CT independently predicted the recurrence of venous thromboembolism (VTE) (OR, 4.67; 95% CI, 2.24–9.74; p<0.001).ConclusionThree months after PE, DVT was not detected by follow-up CT in most patients with PE. RV dilation on the initial CT, central PE, and proximal DVT at the initial presentation were found to predict DVT on follow-up CT, which might predict VTE recurrence.

Risk and incidence of perioperative deep vein thrombosis in patients undergoing gastric cancer surgery.

Venous thromboembolism (VTE) is a potentially fatal perioperative complication. Understanding the risk factors for deep vein thrombosis (DVT) and initiating appropriate prophylaxis is pivotal for reducing the risk of VTE. The purpose of this study was to clarify the perioperative risk factors for DVT in patients undergoing surgery for gastric cancer. We reviewed the findings of lower limb ultrasonography performed in 160 patients who underwent gastrectomy for gastric cancer. The preoperative and postoperative incidence of DVT was 4.4% (7/160) and 7.2% (11/153), respectively. All postoperative DVTs were of the distal type, whereas preoperative DVTs were of the proximal (n = 3) and distal type (n = 4). None of the patients suffered symptomatic VTE. Multivariate analysis indicated that depth of invasion and D-dimer concentration were independent risk factors for preoperative DVT and that gender and performance status were risk factors for postoperative DVT. Receiver operating characteristic analysis revealed that the optimal cut-off D-dimer concentration was 1.4μg/mL. The incidence of perioperative DVT was low for patients undergoing gastric cancer surgery. Therefore, the risk-stratified application of perioperative pharmacologic thromboprophylaxis is thought to be more appropriate than routine pharmacologic thromboprophylaxis for Japanese patients undergoing surgery for gastric cancer.

Risk factors for deep vein thrombosis and pulmonary embolism after traumatic injury: A competing risks analysis.

Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given that recent data suggesting postinjury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of postinjury DVT and PE are different. We examined all adult trauma patients admitted to our Level I trauma center from July 2006 to December 2011 who received at least one surveillance duplex ultrasound of the lower extremities and who were at high risk or greater for DVT. Outcomes included DVT and PE events, and time-to-event from admission. We used competing risks analysis to evaluate risk factors for DVT while accounting for PE as a competing event, and vice versa. Of 2,370 patients, 265 (11.2%) had at least one venous thromboembolism event, 235 DVT only, 19 PE only, 11 DVT and PE. Within 2 days of admission, 38% of DVT cases had occurred compared with 26% of PE. Competing risks modeling of DVT as primary event identified older age, severe injury (Injury Severity Score, ≥ 15), mechanical ventilation longer than 4 days, active cancer, history of DVT or PE, major venous repair, male sex, and prophylactic enoxaparin and prophylactic heparin as associated risk factors. Modeling of PE as the primary event showed younger age, nonsevere injury (Injury Severity Score, < 15), central line placement, and prophylactic heparin as relevant factors. The risk factors for PE and DVT after injury were different, suggesting that they are clinically distinct events that merit independent consideration. Many DVT events occurred early despite prophylaxis, bringing into question the preventability of postinjury DVT. We recommend trauma center quality reporting program measures be revised to account for DVT and PE as unique events. Epidemiologic, level III.

Is Infection an Independent Risk Factor for Venous Thromboembolism? A Population-Based, Case-Control Study

BackgroundThe independent association of recent infection with venous thromboembolism is uncertain. The study aims were to test both overall infection (site unspecified) and specific infection sites as potential risk factors for deep vein thrombosis and pulmonary embolism adjusting for other known venous thromboembolism factors. MethodsBy using Rochester Epidemiology Project resources, we identified all Olmsted County, Minnesota, residents with objectively diagnosed incident deep vein thrombosis or pulmonary embolism over the 13-year period 1988 to 2000 (cases; n = 1303) and 1 to 2 residents without venous thromboembolism matched to each case on age, sex, and incident venous thromboembolism date (controls; n = 1494). Using conditional logistic regression, we tested recent infection and infection site(s) for an association with venous thromboembolism, adjusting for body mass index, smoking, current/recent hospitalization with/without surgery, nursing home confinement, active cancer, trauma/fracture, leg paresis, prior superficial vein thrombosis, transvenous catheter/pacemaker, ischemic heart disease, congestive heart failure, chronic lung or renal disease, serious liver disease, asthma, diabetes mellitus, hormone therapy, and pregnancy/postpartum. ResultsA total of 513 cases (39.4%) and 189 controls (12.7%) had an infection in the previous 92 days (odds ratio, 4.5; 95% confidence interval, 3.6-5.5; P < .0001). In a multivariable analysis adjusting for common venous thromboembolism risk factors, pneumonia and symptomatic urinary tract, oral, intra-abdominal, and systemic bloodstream infections were associated with significantly increased odds of venous thromboembolism. ConclusionsInfection as a whole and specific infection sites in particular are independent risk factors for venous thromboembolism and should be considered as potential indications for venous thromboembolism prophylaxis.

Risk Factors for Deep Vein Thrombosis in Patients Who Undergo Radiofrequency Ablation for Treatment of Varicose Veins

Risk Factors for Deep Vein Thrombosis in Patients Who Undergo Radiofrequency Ablation for Treatment of Varicose Veins

Prevalence and risk factors of deep vein thrombosis in patients undergoing lumbar spine surgery.

Spinal surgery is classified as a moderate risk for DVT. The occurrence of DVT after various spinal surgical procedures was reviewed retrospectively, and the perioperative risk factors in the high-risk group were identified. In addition, the administration of the factor Xa inhibitor to DVT subjects with unstable thrombosis was evaluated to reveal its effectiveness in the prevention of PTE and postoperative complications. This study included 588 subjects who underwent lumbar spine surgery. The patient population consisted of the following four groups: the fracture group (F group), the laminectomy group (La group), the TLIF group (T group), and the long fusion group (Lo group). Bilateral lower limb venous ultrasonography was performed on the day before surgery, the day after surgery, and one week after surgery. The incidence of DVT was determined for each group and potential risk factors were evaluated in the group with the highest incidence of DVT. Subjects with DVT who had unstable thrombosis received anticoagulant therapy (factor Xa inhibitor) and their treatment results were assessed. The overall incidence of DVT was 32.3% (190/588). A significantly high incidence of DVT was observed in the Lo group (54.3%; 75/138). Logistic regression and ROC analysis of potential risk factors in the Lo group identified a D-dimer value of 19.5ug/ml at one week postoperatively as a risk factor of DVT (p=0.02; odds ratio, 4.09; 95% CI, 2.82-7.88). Overall, 15.8% of subjects (30/190) received anticoagulant therapy. These subjects experienced neither PTE nor epidural hematoma. A follow-up ultrasonography performed at three weeks postoperatively detected the disappearance/resolution of DVT in 86.7% of these subjects (26/30). The incidence of DVT varied according to the invasiveness of the procedure. Successful management of DVT hinges on preoperative risk management involving prophylactic treatment and early diagnosis, in order to avoid PTE and other complications.

Incidence of peripheral trophic disorders determined by vein thrombosis of the lower limbs correlated with risk factors by age

Introduction: Venous thromboembolism (VTE), in its clinical spectrum, includes both deep venous thrombosis (DVT) and pulmonary embolism (PE). It is a disease with high incidence and morbidity in hospital and community settings. Venous thromboembolism has various risk factors and there are studies proving that the risk of increasing the incidence of the disease is proportional to the risk factors. Diagnosis, treatment and complications of lower limb deep vein thrombosis (DVT) depend on the anatomical location and extent of the process. The post-thrombotic syndrome (PTS) is the most common complication of deep vein thrombosis (DVT) and clinically it is characterized by chronic pain, edema, enlarged veins, skin induration and other signs of the affected limb, while, in severe cases, it can develop venous ulcers. The incidence of peripheral trophic disorders by age and the prevalence of risk factors for deep vein thrombosis of the lower limbs were examined in this regard. Materials and method: A retrospective study (January 2013 - December 2015) was conducted by collecting data from medical documents available in ""Floreasca"" Emergency Hospital Bucharest, Romania. The patients diagnosed with deep vein thrombosis, on the basis of Doppler ultrasound, were divided into two groups, according to age: group A (59 patients aged ≤50 years) and group B (130 patients aged&gt; 50 years). A number of data from the medical anamnesis, along with clinical and paraclinical data were collected by us and we were interested in the incidence of peripheral trophic disorders caused by deep vein thrombosis of the lower limbs correlated with the risk factors. The study showed the incidence of deep venous thrombosis in a certain age and a certain environment of origin. The incidence of patients who have had a VTE history is half the patients with deep vein thrombosis who have had prophylactic anticoagulant therapy before hospitalization. The incidence of patients who have had prophylactic anticoagulant therapy before hospitalization is 61.1% of the patients with deep vein thrombosis and a VTE history. The incidence of trophic disorders caused by deep vein thrombosis of the lower limbs in patients who have had prophylactic anticoagulant therapy before hospitalization and in patients who also had a history of VTE is higher in those over 50 years old. The study showed the association of some risk factors for venous thrombosis with an age-related factor. Conclusions: Improving preventive strategies and an optimally efficient utilization of these strategies for patients at risk of venous thrombosis can lead to improved clinical outcomes in practice and also to the post-thrombotic syndrome prevention. Taking into consideration the risk factors by age group and a better understanding of epidemiology and the risk factors for the first or recurrent venous thrombosis can lead to optimal use of prophylactic strategies and improved quality of life. DVT affects all age groups and the incidence associated with PTS is high, therefore the prevalence of PTS in general population is considerable.