A Study of Deep Vein Thrombosis in Surgical Practice

Abstract

This was a prospective clinical study performed in the surgical department of MKCG Medical College and Hospital, Berhampur, Odisha, during the period from September 2013 to August 2015. Six hundred and forty eight patients who underwent surgical procedures >1 hour were included in this study to find the incidence of deep vein thrombosis (DVT) development postoperatively. AIMS AND OBJECTIVESIdentifying the possible risk factors and to identify the subgroup of patients needing prophylaxis routinely after a surgical procedure. METHOD OF COLLECTION OF DATAPatients aged >15 years who underwent surgeries (APR, colostomies, abdominal surgeries, hernia repairs, MRM, thyroidectomies, perforation closure etc.) lasting for more than one hour under spinal, epidural and general anaesthesia. Patients unwilling to take part in the study, patients on anticoagulant therapy and patients previously diagnosed with DVT or VTE were excluded from the study. PROCEDUREClinical examination was carried out in the postoperative period to look for limb pain and swelling. D-dimer levels and Doppler USG were used for diagnosis. RESULTS AND CONCLUSIONThe incidence of DVT was 1.23% and the mean age group of the patients affected was 50.5 years. Male-to-female ratio was 1.28:1. OCP intake, smoking, higher BMI, major surgeries under GA and greater and postoperative immobilisation were important risk factors. Colonic surgeries had a greater chance of post-op DVT development. Duplex USG had a high sensitivity and specificity and thus can be considered the gold standard test for diagnosis of DVT, whereas D-dimer has low specificity and specificity thus not reliable for DVT diagnosis post-operatively.