Deep vein thrombosis in medical and surgical Intensive Care Unit patients in a Tertiary Care Centre in North India: Incidence and risk factors

• Main Authors: Ashish Kumar, Yatin Mehta, Tariq Ali, Mukesh Kumar Gupta, Joby V George
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Journal of Anaesthesiology Clinical Pharmacology
• Subjects: Acute Physiology and Chronic Health Evaluation; cardiothoracic vascular surgery; central venous catheter; computed tomography pulmonary angiogram; deep vein thrombosis; pulmonary embolism; venous thromboembolism
• Online Access: http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=2;spage=181;epage=186;aulast=Kumar

Background and Aims: Deep venous thrombosis (DVT) prophylaxis is underutilized, and there is a paucity of data reflecting the incidence of DVT in Indian Intensive Care Unit (ICU) population. We sought to evaluate the incidence and risk factors for DVT in medical and surgical ICU patients with DVT prophylaxis. Material and Methods: The ICU patients more than 18 years old, expected to be in the ICU for more than 48 h were enrolled and DVT prophylaxis were given as per risk and were observed for clinical signs of DVT along with duplex ultrasound until in ICU. The patients receiving anticoagulant for some other reasons were excluded along with those with pregnancy, congenital coagulation disorders and terminal illness. Results: The incidence of DVT was 0.8% (95% confidence interval: 0.78-0.81) in mixed populations (1.6% in medical and 0.5% in surgical). The higher DVT score (DVT (+) 10.75 ± 2.06/DVT (−) 8.75 ± 1.7 P = 0. 0264), Acute physiology and chronic health evaluation (APACHE) IV score (DVT positive patient - DVT (+) 59.25 ± 15.06/DVT negative patients - DVT (−) 44.01 ± 13.74) P = 0. 0292), length of ICU stay ([DVT (+) 26.75 ± 12.87 days/DVT (−) 5.19 ± 6.18] P < 0.010), and inotropes (DVT (+) 50%/DVT (−) 12.3% P = 0. 023) were associated with DVT. Conclusion: The incidence of DVT was 0.8% with prophylaxis. High DVT and APACHE IV score were associated with DVT. Prolonged ICU stay and vasopressors were the risk factors.