Deep Venous Thrombosis and Risk of Consequent Sepsis Event: A Retrospective Nationwide Population-Based Cohort Study

Yeh, Ying‐Tung; Tsai, Sheng-En; Chen, Ying-Cheng; Yang, Shun‐Fa; Yeh, Hung‐Wen; Wang, Bo-Yuan; Yeh, Liang-Tsai; Shih, Nai-Chen; Wang, Yu‐Hsun; Chen, Yin‐Yang; Yeh, Chao‐Bin

doi:10.3390/ijerph18157879

Cited by 8 publications

(4 citation statements)

References 45 publications

(47 reference statements)

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“…Sepsis has been shown to be an independent risk factor for VTD (OR 1.74; 95%CI, 1.59-1.90). Risk factors associated with sepsis include age, diabetes, chronic kidney disease, chronic obstructive pulmonary disease, stroke, malignancy and antibiotic use (27), most of which are risk factors for thrombosis. Among septic patients, those requiring mechanical ventilation (28) had a higher risk of thromboprophylaxis failure, suggesting that the greater the severity of the infectious process, the greater the risk of thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the development of venous thromboembolic disease due to failed thromboprophylaxis.

Perez,

Talero,

Velandia

2023

Preprint

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Introduction: Available evidence to identify factors independently associated with failed thromboprophylaxis (FT) in medical patients is insufficient. The present study seeks to evaluate in hospitalized patients, which clinical factors are associated for the development of FT. Materials and methods: A case-control study nested to a historical cohort, comparing patients who developed failed thromboprophylaxis (cases) with those who did not (controls). Univariate and multivariate regression analysis was performed to define the factors associated with FT. Results: We collected 204 cases and 408 controls (52.4% men, median age 63 years). Seventy-eight point four percent had indication for medical hospitalization. The most frequent thromboprophylaxis scheme was enoxaparin. In the failed thromboprophylaxis group, most of the embolic events corresponded to pulmonary thromboembolism (53.4%). Among cases, BMI was higher (26.3 vs 25 kg/m2, p<0.001), as was the proportion of patients with leukocytosis >13,000 (27% vs 18.9%, p:0.22), and the proportion who required intensive care management (48% vs 24.8%,p<0.001). Factors independently associated with FT were BMI (OR1.04;95%CI 1.00-1.09, p:0.39), active cancer (OR:1.63;95%IC 1.03-2.57,p:0.04), leukocytosis (OR:1.64;95%CI 1.05 - 2.57, p0.03) and ICU requirement (OR:3.67;95%CI 2.31-5.83,p<0.001). Conclusion: Our study suggests that the development of failed thromboprophylaxis is associated with elevated BMI, active cancer, leukocytosis and ICU requirement. Future studies should evaluate whether there is benefit in adjusting the thromboprophylaxis schedule in medical patients with one or more of these factors.

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Section: Discussionmentioning

confidence: 99%

Factors associated with the development of venous thromboembolic disease due to failed thromboprophylaxis.

Perez,

Talero,

Velandia

2023

Preprint

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“…POCUS seems to be of great utility for the identification of deep vein thrombosis-associated complications, which could potentially serve as the initial nidus of sepsis. The major complication is septic thrombophlebitis, whichis commonly seen in intravenous drug users or patients with indwelling central venous catheters and less frequently in the rather rare clinical entity called Lemierre syndrome [ 52 , 53 ]. In septic thrombophlebitis, US shows a non-compressible vein with an anechoic or echogenic thrombus in its lumen, vessel wall thickening and loss of colour Doppler flow.…”

Section: Pocus As a Tool For Diagnosismentioning

confidence: 99%

Point-of-Care Ultrasound: A Multimodal Tool for the Management of Sepsis in the Emergency Department

et al. 2023

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Sepsis and septic shock are life-threatening emergencies associated with increased morbidity and mortality. Hence, early diagnosis and management of both conditions is of paramount importance. Point-of-care ultrasound (POCUS) is a cost-effective and safe imaging modality performed at the bedside, which has rapidly emerged as an excellent multimodal tool and has been gradually incorporated as an adjunct to physical examination in order to facilitate evaluation, diagnosis and management. In sepsis, POCUS can assist in the evaluation of undifferentiated sepsis, while, in cases of shock, it can contribute to the differential diagnosis of other types of shock, thus facilitating the decision-making process. Other potential benefits of POCUS include prompt identification and control of the source of infection, as well as close haemodynamic and treatment monitoring. The aim of this review is to determine and highlight the role of POCUS in the evaluation, diagnosis, treatment and monitoring of the septic patient. Future research should focus on developing and implementing a well-defined algorithmic approach for the POCUS-guided management of sepsis in the emergency department setting given its unequivocal utility as a multimodal tool for the overall evaluation and management of the septic patient.

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“…In addition, DVT may exacerbate the pathophysiologic disorders of sepsis. A large cohort study found that beyond inducing various acute and chronic vascular complications, DVT also served as a risk factor for sepsis [5].…”

Section: Introductionmentioning

confidence: 99%

Risk factors and a nomogram model for deep vein thrombosis in critically ill patients with sepsis: a retrospective analysis

Su,

Tie,

Zhou

et al. 2024

Preprint

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Background Sepsis is one of the risk factors for deep vein thrombosis (DVT). However, studies on risk factors for DVT in critically ill patients with sepsis are limited, and no specific assessment tool is available for evaluating the risk of DVT in this population. We aimed to determine the risk factors of DVT and develop a simple nomogram for this vulnerable population. Methods In this retrospective observational study, patients with sepsis using Sepsis-3 criteria, who were admitted to the intensive care unit (ICU) of West China Hospital of Sichuan University from January 2015 to May 2022, were enrolled. Patients with a diagnosis of DVT before admitting to ICU, cancer, trauma, pregnancy, surgery more than 45 minutes, or long-term use of glucocorticoids were excluded. Patients were assigned to the DVT group or non-DVT group based on the results of ultrasonography. We generated receiver operating characteristic curves (ROC) to calculate the cut-off of the continuous variables. A forest plot and a nomogram were developed by multivariable logistic regression. Results A total of 1057 patients were finally included. The multivariable logistic regression analysis showed that age (≥ 48 years old, odds ratio (OR) = 2.99, 95% confidence interval (CI): 2.19–4.12, P < 0.001), the use of vasoactive drugs (≥ 336 hours, OR = 5.66, 95%CI: 4.05–7.99, P < 0.001), PaO2/FiO2 (≤ 275, OR = 1.68, 95%CI: 1.24–2.27, P < 0.001), respiratory infection (OR = 1.44, 95%CI: 1.02–2.06, P < 0.05), D-dimer level (OR = 1.59, 95%CI: 1.12–2.26, P < 0.05), fibrinogen level (OR = 1.45, 95%CI: 1.09–1.95, P < 0.05), physical prophylaxis (OR = 0.51, 95%CI: 0.37–0.71, P < 0.001) were independently associated with DVT. There were no significant differences in the insertion of the central venous catheter (CVC) or peripherally inserted central catheter (PICC), Sequential Organ Failure Assessment (SOFA) score, duration of mechanical ventilation, stay in ICU, and length of hospitalization between the two groups, while the DVT group had a higher proportion of use of pharmacologic thromboprophylaxis (61.8% vs. 47.2%, P < 0.001). Conclusions In critically ill patients with sepsis, physical prophylaxis was found as an independent protective factor for DVT. Advanced age, long-term use of vasoactive drugs, elevated D-dimer levels, decreased fibrinogen levels, low oxygenation index, and respiratory infection were independent risk factors for DVT.

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Deep Venous Thrombosis and Risk of Consequent Sepsis Event: A Retrospective Nationwide Population-Based Cohort Study

Cited by 8 publications

References 45 publications

Factors associated with the development of venous thromboembolic disease due to failed thromboprophylaxis.

Factors associated with the development of venous thromboembolic disease due to failed thromboprophylaxis.

Point-of-Care Ultrasound: A Multimodal Tool for the Management of Sepsis in the Emergency Department

Risk factors and a nomogram model for deep vein thrombosis in critically ill patients with sepsis: a retrospective analysis

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