Factors Of Deep Venous Thrombosis Research Articles

Analysis of related factors of deep venous thrombosis after spinal cord injury

To explore the high-risk factors of deep vein thrombosis (DVT) formation in patients after spinal cord injury (SCI) and to provide some reference value for the prevention of DVT. Eighty-five patients with spinal cord injury caused by thoracolumbar burst fracture from January 2016 to December 2017 were selected as subjects. All patients were followed up for 6 months, of which 5 cases were lost and 80 cases were finally included. According to whether there was deep vein thrombosis, the patients were divided into DVT group (35 cases) and control group (45 cases). The clinical data were statistically analyzed by SPSS 22.0 statistical software, and the high-risk factors of spinal cord injury were analyzed by multivariate Logistic regression. Thirty-five of the 80 patients with spinal cord injury developed deep venous thrombosis (incidence rate was about 43.7%). The average age of DVT group [(47.77±10.76) years ] was higher than that of non-DVT group [(37.35±10.20) years ], and there was a significant difference between two groups (χ2=19.56, P<0.000). Patients with body mass index≥28 kg/m2, combined with diabetes mellitus, smoking history, no limb pressure therapy and ankle pump exercise had a high incidence of DVT. The incidence of ASIA grade A in the spinal cord injury was higher in the DVT group (48.5%) than in the non-DVT group (20%) (P<0.05). The ROC curve was drawn by MedCalc 15.8 software : when the age was more than 45 years old, the incidence of deep venous thrombosis was higher, the specificity was 84.4%, and the sensitivity was 72.6%. Multivariate Logistic regression analysis showed the following factors : patient age >45 years [OR=1.665, 95% CI (1.102-2.516)], diabetes history [OR=3.273, 95% CI (1.291-8.295)], smoking history [OR=3.302, 95% CI (1.267-8.605)], spinal cord injury ASIA grade A [OR=5.736, 95% CI (3.152-11.74)], non-limb air pressure therapy and ankle pump exercise [ OR=3.013, 95% CI (0.116-0.789)] was statistically significant (P<0.05) and was a high risk factor for deep vein thrombosis. The incidence of DVT is still high in patients with spinal cord injury after surgery. When one or more risk factors such as age >45 years, history of diabetes, smoking history, and ASIA grade A of spinal cord injury is present, preventive measures should be taken in advance, it is of great significance to prevent the formation of deep vein thrombosis.

Analysis of related factors of deep venous thrombosis after spinal cord injury

To explore the high-risk factors of deep vein thrombosis (DVT) formation in patients after spinal cord injury (SCI) and to provide some reference value for the prevention of DVT. Eighty-five patients with spinal cord injury caused by thoracolumbar burst fracture from January 2016 to December 2017 were selected as subjects. All patients were followed up for 6 months, of which 5 cases were lost and 80 cases were finally included. According to whether there was deep vein thrombosis, the patients were divided into DVT group (35 cases) and control group (45 cases). The clinical data were statistically analyzed by SPSS 22.0 statistical software, and the high-risk factors of spinal cord injury were analyzed by multivariate Logistic regression. Thirty-five of the 80 patients with spinal cord injury developed deep venous thrombosis (incidence rate was about 43.7%). The average age of DVT group [(47.77±10.76) years ] was higher than that of non-DVT group [(37.35±10.20) years ], and there was a significant difference between two groups (χ2=19.56, P<0.000). Patients with body mass index≥28 kg/m2, combined with diabetes mellitus, smoking history, no limb pressure therapy and ankle pump exercise had a high incidence of DVT. The incidence of ASIA grade A in the spinal cord injury was higher in the DVT group (48.5%) than in the non-DVT group (20%) (P<0.05). The ROC curve was drawn by MedCalc 15.8 software : when the age was more than 45 years old, the incidence of deep venous thrombosis was higher, the specificity was 84.4%, and the sensitivity was 72.6%. Multivariate Logistic regression analysis showed the following factors : patient age >45 years [OR=1.665, 95% CI (1.102-2.516)], diabetes history [OR=3.273, 95% CI (1.291-8.295)], smoking history [OR=3.302, 95% CI (1.267-8.605)], spinal cord injury ASIA grade A [OR=5.736, 95% CI (3.152-11.74)], non-limb air pressure therapy and ankle pump exercise [ OR=3.013, 95% CI (0.116-0.789)] was statistically significant (P<0.05) and was a high risk factor for deep vein thrombosis. The incidence of DVT is still high in patients with spinal cord injury after surgery. When one or more risk factors such as age >45 years, history of diabetes, smoking history, and ASIA grade A of spinal cord injury is present, preventive measures should be taken in advance, it is of great significance to prevent the formation of deep vein thrombosis.

Occurrence of deep venous thrombosis in adult burn patients and its risk factors

Objective: To investigate the occurrence and risk factors of deep venous thrombosis (DVT) in adult burn patients. Methods: The clinical data of 1 219 adult burn patients admitted to the Department of Burns of Zhengzhou First People's Hospital from January 1, 2015 to August 31, 2016, conforming to the study criteria, were analyzed retrospectively by the method of case-control study, including 811 males and 408 females, aged 18-102 years. According to whether DVT occurred during hospitalization or not, the patients were divided into group DVT (n=12) and non-DVT group (n=1 207). The incidence of DVT, the diagnosis time of DVT, affected limbs, and DVT classification were counted and recorded. The gender, age, total burn area, D-dimer, lower limb burn, full-thickness burn, femoral vein indwelling central venous catheter (CVC) , inhalation injury, sepsis/infection shock, surgical operation, and infusion of concentrated red blood cells of patients between the two groups were compared with chi-square test, and then the indicators with statistically significant differences between the two groups were processed by multivariate binary logistic regression analysis to screen the independent risk factors of DVT in the adult burn patients. Results: (1) The incidence of DVT of adult burn patients was 0.98% (12/1 219), and DVT was diagnosed 24-138 days after injury, with a median of 61.5 days. DVT occurred in the right lower limb of 2 patients, left lower limb of 8 patients, and bilateral lower limbs of 2 patients, and DVT classification included 6 cases of mixed type and 6 cases of peripheral type. (2) There were no statistically significant differences in gender, age, and full-thickness burn of patients between the two groups ( χ(2)=1.524, 0.021, 3.115, P>0.05). There were statistically significant differences in total burn area, lower limb burn, inhalation injury, sepsis/infection shock, D-dimer, femoral vein indwelling CVC, surgical operation, and infusion of concentrated red blood cells among patients between the two groups (χ(2)=17.975, 6.206, 3.987, 8.875, 5.447, 15.124, 10.735, 14.031, P<0.05 or P<0.01). (3) Total burn area, D-dimer, and femoral vein indwelling CVC were independent risk factors for DVT in adult burn patients (odds ratio=10.927, 4.762, 9.394, 95% confidence interval=3.078-38.789, 1.197-18.934, 2.631-33.540, P<0.05 or P<0.01). Conclusions: The incidence of DVT in adult burn patients is relatively low, and the diagnosis time of DVT is 3 weeks after burn, with DVT classification of mixed type and peripheral type. The total burn area, femoral vein indwelling CVC, and D-dimer are independent risk factors for predicting DVT in adult burn patients.

Value of assessment of factor XI in patients with myeloproliferative neoplasms with and without thrombotic events

Background Although high levels of factor XI and contact factors have been implicated as a risk factor for deep venous thrombosis and possibly cardiovascular disease in some cancers like prostatic cancer, the relationship between elevated factor XI activity and thrombosis in myeloproliferative neoplasm (MPN) is not established yet. Aim The aim was to study the possible relation between factor XI in patients with MPNs with and without thrombotic events in comparison with normal controls and the possible effect of its altered level to occurrence of such events. Patients and methods This is a cross-sectional study conducted in Ain Shams University Hospitals and included 50 patients with MPN. Patients were investigated to assess the relation between level of factor XI and thrombus formation. Results There was no statistically significant difference between the level of factor XI and thrombotic incidence in patients with MPN. Conclusion This study focusing on the contribution of factor XI to the thrombotic risk in patients with MPN showed that there was no link between the high levels of factor XI and the thrombotic risk in patients with MPN.

Hyperhomocysteinemia is associated with deep vein thrombosis in Nigerian patients

Background Hyperhomocysteinemia is a modifiable risk factor associated with deep venous thrombosis (DVT). Low serum concentrations of vitamin B12 and folate are modifiable causes of hyperhomocysteinemia. This study was carried out to determine the prevalence of hyperhomocysteinemia in Nigerian patients with DVT and also to assess the association of homocysteine with vitamin B12 and folate. Patients and methods A case–control study was carried out in which serum homocysteine, vitamin B12, and folate levels were measured in 45 Doppler ultrasound confirmed cases of DVT and 43 controls. Hyperhomocysteinemia was defined by serum levels more than 15.0 μmol/l, low serum folate less than 3 μg/l, and low serum vitamin B12 less than 160 ng/l. Results The prevalence of hyperhomocysteinemia in DVT patients was 20 (44.4%) compared with four (9.35%) in the control (P Conclusion Hyperhomocysteinemia may be a risk factor for DVT in the Nigerian population but may not be responsible for thrombosis in all cases. There was however no significant correlation between serum level of homocysteine and serum levels of vitamin B12 and folate in DVT patients. Therefore, larger sized sample studies should be carried out to investigate the relationship between hyperhomocysteinemia and related vitamins as well as genetic causes of hyperhomocysteinemia in DVT patients in our environment.

Embolie pulmonaire et agénésie de veine cave inférieure : une association inhabituelle

Inferior vena cava agenesis is a rare congenital anomaly, generally associated with thrombophilic conditions, and a predisposing factor for deep venous thrombosis (DVT), rarely complicated by pulmonary embolism, in a young population with atypical clinical features and frequent absence of risk factors. We report the case of a 30-year-old woman who developed a right iliac DVT, initially presenting as a low back pain and complicated by a pulmonary embolism, 8 months after a sleeve gastrectomy. Chest CT angiography revealed abnormalities that led to the diagnosis of inferior vena cava agenesis. Thrombophilic screening showed a heterozygous prothrombin gene mutation G20210A and hyperhomocysteinemia. The patient was treated with rivaroxaban with good results after 2 years of follow-up. In young patients without risk factors developing a deep venous thrombosis, an inferior vena cava anomaly should be considered. Although no therapeutic consensus has been currently established, inferior vena cava agenesis seems to be associated with a high prevalence of thrombophilic disorders. Screening could be useful, particularly in patients with a thrombotic family history.

Risk Assessment of Deep Venous Thrombosis and Its Influencing Factors in Burn Patients

The objective of this study is to explore the relevant risk factors of deep venous thrombosis (DVT) in burn patients. A retrospective analysis was conducted for the medical records of 845 hospitalized burn patients from September 2012 to August 2017. Caprini thrombosis risk assessment scale (CTRAS) was employed for evaluating the risks of DVT. Based upon whether or not DVT occurred, they were divided into non-DVT group (n = 830) and DVT group (n = 15). Among 360 (42.7%) patients with high-risk Caprini scores, only 30 patients received color Doppler examination of lower limb veins, and 15 patients were diagnosed as DVT with a diagnostic rate of 1.8%. Caprini scores of non-DVT and DVT groups were 4.30 ± 2.71 and 9.87 ± 1.46 points, respectively. There was statistically significant difference (P < .05). As revealed by stepwise Logistic regression analysis, age, lower limb burn, wound infection, femoral vein catheterization, and long bedriddening time (>40 days) were independent risk factors for DVT. Burn patients are particularly prone to develop DVT. Age, wound infection, femoral vein catheterization, and long bedriddening time (>40 days) are risk factors. Aggressive preventive measures of DVT should be implemented.

78-Year-Old Woman With Intermittent Chest Pain and Palpitations

78-Year-Old Woman With Intermittent Chest Pain and Palpitations

Clinical characteristics and nursing of lower extremity deep vein thrombosis in elderly patients in Intensive Care Unit of Neurology Department

Objective To analyze the clinical characteristics of lower extremity deep venous thrombosis (DVT) in elderly patients in Intensive Care Unit (ICU) of Neurology Department, and to provide evidence for early implementation of preventive strategies. Methods Totally 229 patients who were admitted to the ICU of Neurology Department in a hospital from March 2017 to October 2018 were collected as the participants of the study and divided into the elderly group (age≥60 years) and non-elderly group (age<60 years) according to their ages. Self-designed questionnaire was used to collect the patients' general information, relevant factors of the lower extremity DVT, and information of commonly seen problems in elderly population such as history of hypertension and diabetes. SPSS 22.0 was used for data analysis. Results Among the 229 patients, 97 were diagnosed as lower extremity DVT, the incidence was 42.4%. Among them, the number of lower extremity DVT in the elderly group was 62, and the incidence was 57.4%, while the number in the non-elderly group was 35, and the incidence was 28.9%, and there was statistically significant difference between the two groups (P 0.05) , and the main type of DVT was intramuscular venous thrombosis. Conclusions Ischemic cerebrovascular disease, high level fibrinogen accompanied by hypertension, diabetes mellitus and heart disease are the main factors of DVT formation in the lower extremity of elderly patients in ICU of Neurology Department. Reducing hormone use is the protective factor of DVT prevention in lower extremities. Neurological ICU needs to pay early attention to the occurrence of DVT in the lower extremities of the elderly, especially the intramuscular venous thrombosis. Early prevention and interventions should be initiated to reduce the incidence of DVT in the lower extremities of elderly patients in Neurological ICU. Key words: Venous thrombosis; Lower extremity; Department of Neurology; Intensive Care Unit

Assessment of the frequency of deep venous thromboembolism in obstructive sleep apnea syndrome

The present study aimed to investigate the frequency of deep venous thrombosis (DVT) among patients with obstructive sleep apnea syndrome (OSAS). Patients who referred the preliminary diagnosis of OSAS were included in this study. D-dimer levels of all patients were measured, and D-dimer (+) patients were evaluated by Doppler USG of the lower-extremity. Mean age of the patient group was 52 ± 12 years and 31.8% (76/239) were women. The rate of D-dimer positivity among severe-OSAS cases (15/85) was significantly higher compared to the rest (13/154) (17.6% and 8.4%, respectively; p = 0.034). The risk of D-dimer positivity was elevated by 2.3 folds in severe-OSAS cases (OR: 2,324, 95% confidence interval: 1.048–5.152). Among 28 D-dimer (+) cases, 4 (14.2%) had DVT as demonstrated by USI of the lower-extremity. All four cases with DVT had severe OSAS. D-dimer was positive in 17.6% (15/85) of all severe OSAS cases. DVT was diagnosed in 4.7% (4/85) of severe-OSAS cases. DVT frequency was 26.6% (4/15) in D-dimer (+) severe-OSAS. Findings of this study indicate that severe-OSAS can be a significant risk factor for DVT. Additionally, data obtained in this study underline the benefits of questioning severe-OSAS patients with respect to DVT symptoms, investigating D-dimer levels and evaluating D-dimer (+) severe-OSAS cases for DVT prophylaxis.

The incidence and risk factor of deep venous thrombosis after arthroscopically assisted anterior cruciate ligament reconstruction

PurposeTo retrospectively analyze the incidence and risk factors of deep venous thrombosis (DVT) detected by ultrasonography after arthroscopically assisted Anterior Cruciate Ligament Reconstruction (ACLR). MethodsWe retrospectively reviewed medical records of arthroscopically assisted ACLR surgery performed at our institution between 2012 and 2015. Revision ACLR, bone patella tendon bone (BTB) graft reconstruction, and concomitant multiple ligament reconstructions were excluded. We performed a standardized double-bundle reconstruction procedure using hamstrings graft for ACLR. All patients routinely received DVT screening by using venous ultrasonography on postoperative day 7 from 2012 to 2013, and postoperative days 7 and 14 from 2014 to 2015. The prevalence of DVT was calculated and clinical factors such as age, gender, Body Mass Index (BMI), operative time, and duration of tourniquet application were evaluated in relation to the risk factor of DVT. ResultsTwo hundred and fifty-six patients (129 men and 127 women) with a mean age of 28.9 were enrolled. Sixteen patients (6.6%) were detected with DVT on postoperative day 7. Among 146 patients who received venous ultrasonography on both postoperative days 7 and 14, DVT were detected in five additional patients on postoperative day 14. In a total of 21 patients who were diagnosed with DVT, two were proximal, the remaining 19 were distal, and no patient had progressed to pulmonary embolism (PE). In terms of predisposing factors for developing DVT on postoperative day 7, only age ≥30 showed a statistically significant higher risk of DVT (P = 0.03). ConclusionIncidence of DVT after ACLR detected by ultrasonography on postoperative day 7 was 6.6%. Patients aged ≥30 years have a potentially higher risk for developing DVT. Great care for DVT should be taken if prolonged immobilization is applied after ACLR surgery. Level of evidenceLevel Ⅳ

Thrombophlebitis hiding under a KILT \u2013 case report on 40\u2009years long-term follow-up of neonatal renal vein thrombosis

BackgroundNeonatal renal vein thrombosis is a recognised cause of renal and inferior caval vein atresia (IVCA). However, the long-term impact of the condition is underrecognized with a high burden of morbidity for the patient, especially in adulthood. IVCA has been shown to be an independent risk factor for deep venous thrombosis (DVT) with a high risk of recurrence. The acronym KILT for kidney and inferior vena cava anomaly with leg thrombosis summarizes the pathological situation.Case presentationWe present the case of a 40-year-old patient with pain in the right lower limb resulting from acute thrombophlebitis. No risk factors could be identified. His history was remarkable with two episodes of deep venous thrombosis first of the left, then the right leg 22 years earlier; at that time also, no risk factor was identified. Because of the idiopathic character of that thrombosis, the patient remained on long-term anticoagulation with phenprocoumon. The present thrombophlebitis occurred while the INR was not therapeutic in the preceding weeks. A CT with contrast showed atresia of the inferior vena cava and of the right kidney, and presence of numerous collaterals. A thorough medical history revealed a renal vein thrombosis as a neonate. Anticoagulation was intensified, and stent placement became necessary after a further 2 years.Discussion and conclusionsKILT syndrome is a rare but underrecognized condition. Complications may arise in young adulthood only, and it is of prime importance to instruct parents of the pediatric patient of the possible consequences of renal vein thrombosis and to assure guidance from the treating physicians throughout adulthood. Diagnosis of IVCA is by CT with contrast or by MRI, and lifelong anticoagulation may be necessary. Since the KILT syndrome is widely underdiagnosed, we challenge the clinicians to keep it in mind when confronted with thrombophlebitis or thrombosis of the young, male and with no other identifiable risk factors for deep vein thrombosis.

Incidence and risk factor analysis of deep venous thrombosis in patients with severe traumatic brain injury

To estimate the incidence and risk factors for deep venous thrombosis (DVT) in patients with severe traumatic brain injury (TBI) treated in the intensive care unit (ICU). 105 patients with TBI admitted to the First Affiliated Hospital of University of Science and Technology of China from January 2016 to June 2018 were enrolled [Glasgow coma scale (GCS) 3-8; concise injury score for other parts ≤ 3]. All patients did not receive any medication or physical measures to prevent DVT during hospitalization. Bilateral compression Doppler ultrasounds of the double lower limbs and upper limbs were performed to clarify the occurrence of DVT on the first day of admission and twice a week until ICU discharge or the death of patient. The examination was performed by a senior ultrasound doctor. It was defined as DVT as long as any deep vein had thrombosis. Patients were divided into two groups according to whether DVT occurred or not during hospitalization. Clinical data such as body mass index (BMI), coagulation index, platelet count (PLT) and deep venous catheterization were obtained from the clinical chemistry laboratory database and patient files. Logistic regression was used to analyze the risk factors of DVT. Binary Logistic regression was used to calculate the predictive probability of risk factors. The predictive value of risk factors and predictive probability to the occurrence of DVT was analyzed by receiver operating characteristic (ROC) curve. In 105 patients with simple TBI, 42 patients developed DVT during hospitalization, and the incidence of DVT was 40%. Univariate Logistic regression showed that high BMI [odds ratio (OR) = 1.490, 95% confidence interval (95%CI) = 1.174-1.891, P = 0.001], high PLT (OR = 1.023, 95%CI = 1.006-1.040, P = 0.007), shorten activated partial thromboplastin time (APTT; OR = 0.913, 95%CI = 0.853-0.978, P = 0.010) and catheterization in deep vein (OR = 0.114, 95%CI = 0.026-0.493, P = 0.004) were risk factors for DVT. It was shown by multivariate regression analysis that high BMI (OR = 1.378, 95%CI = 1.411-1.665, P = 0.001), high PLT (OR = 1.017, 95%CI = 1.003-1.032, P = 0.020), low APTT (OR = 0.920, 95%CI = 0.860-0.982, P = 0.012) and catheterization in deep vein (OR = 0.113, 95%CI = 0.029-0.443, P = 0.002) were independent risk factors for DVT. The predictive probability formula: Logit P = -4.673+0.321×BMI-0.083×APTT+0.017×PLT-2.181×catheterization in deep vein. It was shown by ROC curve analysis that high BMI, high PLT, low APTT and catheterization in deep vein could predict the occurrence of DVT in severe TBI patients, and the area under ROC curve (AUC) was 0.775, 0.709, 0.709 and 0.680, respectively. The AUC of prediction probability was 0.890, and its sensitivity and specificity were respectively increased to 88.10% and 85.71%. The incidence of DVT was higher in patients with simple severe TBI. High coagulation, high BMI, high PLT and catheterization in deep vein are the independent risk factors for DVT.

The strategy of zero-mortality due to postoperative VTE in patients with colorectal cancer.

511 Background: The best method of venous thromboembolism (VTE) prevention after surgery for colorectal cancer remains unclear. It is reported that about 20-40% of high-risk patients were diagnosed as DVT and 2-4% was diagnosed as PE and its mortality rate is 0.5-1.0%. The aim of this study is to evaluate the incidence of postoperative VTE patients with colorectal adenocarcinoma and to evaluate the efficacy of VTE preventive strategy. Methods: A total of 264 patients who had undergone curative surgical resection for colorectal cancer at Tokushima University Hospital were included in this study (n = 264 colon: rectum = 1:0.57). All patients were measured D-dimer preoperatively. When D-dimer was ≥ 1.1, lower extremities ultrasonography (US) was performed. All patients were treated with Heparin (10,000U/24h) continuously intravenous injection from the day of surgery, and administered Enoxaparin (2,000U/24h) subcutaneous injection after 24h of the operation. Results: In all 264 patients, 74 (28%) were D-dimer ≥ 1.1 and 16 (6%) diagnosed VTE in US (proximal:distal type n = 6:1). 239 (91%) were treated with postoperative anticoagulant therapy. 2 developed perioperative VTE (symptomatic: asymptomatic = 1:1) and after discharge 12 developed postoperative VTE and mortality rate of VTE was 0%. Univariate analysis indicated that obesity (BMI ≥ 25), hyperlipidemia and preoperative PE were risk factors for deep venous thrombosis (DVT) (p &lt; 0.0001, 0.014, 0.0135, respectively) and multivariate analysis revealed that obesity was an independent risk factor for postoperative DVT (p &lt; 0.0001). Conclusions: Obesity (BMI ≥ 25) was independent risk factor for postoperative VTE. Our preventive protocol including screening using D-dimer and lower extremities US and treatment with Enoxaparin is considered as effective for prevention of postoperative VTE.

The Real-World Treatment Status of Venous Thromboembolism in Underdeveloped Areas of Southwestern China

Background: Little is known about the current management status of venous thromboembolism (VTE) in the underdeveloped areas of China, where it is the third most frequent cardiovascular disease. We aimed to investigate the status of anticoagulant use of VTE in southwestern China and assess the related factors of deep venous thrombosis (DVT)-complicated pulmonary embolism (PE). Methods: We extracted data from YiduCloud database from July 1999 to November 2018 and performed a cross-sectional survey including 36,812,353 medical records in seven medical centers. Demographics and laboratory tests were collected and analyzed. Findings: A total of 7353 patients with VTE (mean age 64·3±17·5 years) were included in the study and were divided into the DVT group (only DVT), PE group (only PE), and DVT-PE group (DVT complicated PE). A total of 4579 (62·3%) patients were given traditional anticoagulants, and only 6·5% reached the international normalized ratio (INR) therapeutic levels (2·0-3·0). Only 510 (6·9%) patients were treated with novel oral anticoagulants (NOACs), and 2264 (30·8%) patients were not administered any anticoagulants. Patients in the DVT-PE group (10·9%) used NOACs more than those in the DVT group (8·8%). Moreover, logistic analysis demonstrated that older patients who were male and had higher INR, lipoprotein a, alanine aminotransferase (ALT) and direct bilirubin (DBIL) had higher risk of complicated PE. Interpretation: Nearly one-third of the VTE patients did not receive any anticoagulant therapies, and NOACs were insufficiently used. Even in patients under traditional anticoagulants, INR was poorly controlled. Chinese doctors need to administrate the optimal anticoagulation therapy for patients with DVT. Funding Statement: This work was supported by the National Natural Science Foundation of China (grant numbers 81170188 and 30971212), the Natural Science Foundation of Chongqing (grant number CSCT 2009BB5069), and the Chongqing Municipal Health and Family Planning Commission (grant numbers 2016HBRC001 and 2016XMSB 0003767). Declaration of Interests: The authors declare that there is no conflict of interest. Ethics Approval Statement: The Human Research Committee of Chongqing Medical University approved this study and waived the need for informed consent. Participants were enrolled if the patients were diagnosed with DVT or/and PE and if they ever received treatment in the seven medical centers. A total of 7353 patients with VTE were included in the study and were divided into the DVT group (only DVT), PE group (only PE), and DVT-PE group (DVT complicated PE).

Analysis of related factors of deep venous thrombosis in upper extremity after PICC catheterization

Objective To investigate the related risk factors of upper extremity deep venous thrombosis associated with peripherally inserted central catheter(PICC). Methods From January 2014 to February 2018, 300 patients with PICC in the No.117 Hospital of the Chinese People's Liberation Army were selected in the study, of whom 30 patients developed deep venous thrombosis(thrombosis group), the other 270 patients had no deep venous thrombosis(non-thrombotic group). General data of the patients (gender, age, body mass index), catheter technical parameters(number of punctures, length of catheter, position of catheter tip), retention vessel index(inner side of catheter, indwelling vein, internal diameter of catheter), past history(history of hypertension, history of diabetes, history of oncology, history of cancer chemotherapy, history of smoking, history of blood clots, history of PICC, or CVP insertion), and laboratory tests(platelet count, plasma D-dimer, plasma fibrin original, prothrombin time) were collected.Univariate analysis was used to find out the differences between the thrombosis group and the non-thrombosis group.Logistic regression analysis was used to identify the risk factors for deep vein thrombosis of the upper extremities after PICC catheterization. Results Univariate analysis showed that variables that differed between the thrombus group and the non-thrombosis group included catheter tip location, diameter of the cannulated vein, history of cancer, history of chemotherapy, plasma D-dimer (χ2=4.556, 10.973, 11.940, 5.357, 11.623, P=0.033, 0.001, 0.001, 0.021, 0.001). Multivariate Logistic regression analysis showed that the risk factors of upper extremity deep venous thrombosis after PICC catheterization were catheter tip placement on the upper vena cava 2/3, catheter vein diameter<4mm, tumor history and chemotherapy history(P=0.014, 0.023, 0.017, 0.028). Conclusion The risk factors of upper extremity deep venous thrombosis after PICC catheterization are catheter tip placed on the upper 2/3 of the superior vena cava, diameter of the catheter vein<4 mm, tumor history and chemotherapy history. Key words: Catheterization, central venous; Catheterization, peripheral; Vena cava, superior; Thrombosis; Risk factors

Analysis of risk factors for deep venous thrombosis in patients with gynecological malignant tumor: A clinical study.

Objectives:To determine the clinical characteristics and risk factors of Deep Venous Thrombosis (DVT) in patients with gynecological malignant tumor, facilitating gynecologists better prevent the fatal complication.Methods:The patients with gynecological malignant tumor treated in department of gynecology of our hospital between May 2013 and May 2018 were reviewed retrospectively. The clinical data of patients including gender, age, tumor staging, adenocarcinoma, surgery, operation time, hypertension, hyperlipemia, diabetes, coronary heart disease, radiotherapy, chemotherapy, hospital stay, and postoperative rehabilitation exercise were collected to analyze the clinical characteristics of patients and determine the risk factors of DVT.Results:In the current study, 67 patients were included in DVT group, and 554 patients were included in Non-DVT group. There were significant differences in age, hypertension, hyperlipemia, operation time, adenocarcinoma, tumor staging, radiotherapy and postoperative rehabilitation exercises between DVT and non-DVT groups (p<0.05). However, there was no significant differences in gender, coronary heart disease, diabetes, surgical treatment and hospital stay (p>0.05). In multivariate analysis, the factors including age, hypertension, adenocarcinoma, radiotherapy, and hyperlipemia were independent risk factors, while rehabilitation exercise was protective factor for DVT.Conclusion:In cases of gynecological malignant tumor, DVT screening should be given due importance, especially for those patients with old age, hypertension, hyperlipemia, adenocarcinoma, or history of radiotherapy. Rehabilitation exercise should be encouraged in these patients.

Circulating platelet-neutrophil aggregates as risk factor for deep venous thrombosis.

Background Platelet-neutrophil aggregates (PNAs) are fundamental mechanisms linking hemostasis and inflammatory processes. Elevated level of PNAs have been reported in inflammatory diseases and coronary artery diseases. However, studies on the correlation between PNAs formation and deep venous thrombosis (DVT) are not available. Methods A total of 92 participants were involved in this study, including 32 cases with DVT and 60 cases without DVT. Blood samples coagulated by K2-EDTA or sodium citrate were prepared for blood cell count and blood smears. PNAs and platelet activation were measured using flow cytometry. The correlation between platelet activation level and PNAs level was analyzed by linear regression. Receiver operating characteristic (ROC) analysis was performed, assessing the prognostic performance of PNAs to predict potential risk of DVT occurrence. Results PNAs was found in the blood smears of patients with DVT. Significant increased level of PNAs was identified in DVT group (medium 8.43%, interquartile range [IQR] 4.11%-15.69%), compared with that in control group (5.16%, IQR 2.40-9.60, p<0.01). The DVT group also showed a dramatic elevated level of total platelet activation (medium 16.06%, IQR 6.04-22.05) vs. control group (11.26%, IQR 5.54-19.99, p<0.05). The PNAs level was correlated with total platelet activation (r2=0.58, p<0.0001). A significantly high odds ratio (OR) of DVT occurrence was identified when the level of PNAs was higher than 7.4% (OR 3.60, 95% confidence interval [CI] 1.463-8.838, p<0.01). Conclusions An elevated level of PNAs was associated with risk of DVT occurrence, which might be a suitable marker predicting DVT development.

Prevalence and risk factors of deep venous thrombosis in patients with longitudinally extensive transverse myelitis: one center data from China

ObjectiveDeep venous thrombosis (DVT) is a severe complication in longitudinally extensive transverse myelitis (LETM) patients. It may interfere with LETM treatment and delay the recovery of the spinal dysfunction. However, there is less data about the prevalence and risk factors of DVT in patients with LETM. We analyzed data retrospectively to ascertain the prevalence of DVT and the clinical risk factors for DVT.MethodsClinical data on 255 LETM patients were collected from medical records. All patients were performed color Doppler ultrasound(US) to screen DVT in both lower extremities when admitted. Clinical characteristics of LETM patients with DVT were compared with those without DVT using corresponding statistical methods. Multivariate logistic regression was performed to identify risk factors related to DVT.ResultsDVT were found in 11.8% patients with LETM. Univariate analysis showed that age, muscle force and elevated baseline D-dimer were risk factors for DVT. After multivariate logistic regression, age, dyslipidemia, segments of lesions, and elevated baseline D-dimer remained significant independent risk factors.ConclusionsDVT is common in patients with LETM and related to patient’s age, dyslipidemia, segments of lesions, and elevated baseline D-dimer. Early recognition of DVT and thrombosis prophylaxis are appropriate in patients with LETM.

Risk Factors for Venous Thromboembolism After Admission for Traumatic Subdural Hematoma at Level I Trauma Center: Large Single-Institution Series

Traumatic subdural hematomas (tSDHs) have high morbidity and mortality and often require neurosurgical intervention. The risk of venous thromboembolism (VTE) after tSDH ranges from 1%-20%, yet a consensus chemoprophylaxis protocol does not exist. An increased understanding of VTE risk factors following tSDH may inform development of prophylaxis guidelines. Retrospective analysis of a prospective, single-institution Level I trauma center database identified the incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in consecutive tSDH patients from 1990-2015. Univariate and multivariate analyses were used. Of 3024 tSDH patients, 682 (22.6%) required neurosurgical intervention in the form of an intracranial pressure monitor, external ventricular drain (EVD), or craniotomy/craniectomy. Overall, 129 (4.3%) and 20 (0.7%) patients were diagnosed with a DVT or PE. Risk factors for DVT included age =60 (odds ratio [OR]=1.5, P=0.039), preexisting endocrine disorder (OR=4.1, P=0.001), hospital length of stay =7 days (OR=4.7, P < 0.001), intensive care unit length of stay =7 days (OR=3.6, P < 0.001), and lower extremity fracture (OR=2.1, P=0.004); GCS >3 was associated with a reduced DVT risk (OR=0.6, P=0.020). Risk factors for PE included intensive care unit length of stay =7 days (OR=9.7, P < 0.001) and lower extremity fracture (OR=4.7, P=0.002). Neurosurgical intervention did not independently increase VTE risk but was associated with increased hospital length of stay (P < 0.001). While overall VTE risk is low following tSDH, elderly patients and those with severe injuries requiring prolonged hospitalizations have increased thrombotic risk. Development of tiered VTE prophylaxis regimens based on early postinjury thrombotic risk profiles warrants future study.