Incidence of venous thromboembolism in psychiatric units

Delluc, Aurélien; Montavon, Stéphanie; Canceil, Olivier; Carpentier, Marc; Nowak, Emmanuel; Mercier, Bernard; Bressollette, Luc; Etienne, Sylvie; Walter, Michel; Mottier, Dominique; Lacut, Karine

doi:10.1016/j.thromres.2012.10.002

Cited by 19 publications

(20 citation statements)

References 17 publications

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“…None of the patients audited had received a risk assessment. Our findings are also supported by a large study in France, in which 458 psychiatric in-patients were followed for 90 days, 6 and a study conducted in Japan ( N = 190) where doppler ultrasound scanning was used to ensure that even asymptomatic VTE was recorded. 5 Both of these studies found a high incidence of VTE among psychiatric in-patients.…”

Section: Discussionsupporting

confidence: 80%

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Venous thromboembolism risk in psychiatric in-patients: a multicentre cross-sectional study

et al. 2019

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Aims and methodWe assessed venous thromboembolism (VTE) risk, barriers to prescribing VTE prophylaxis and completion of VTE risk assessment in psychiatric in-patients. This was a cross-sectional study conducted across three centres. We used the UK Department of Health VTE risk assessment tool which had been adapted for psychiatric patients.ResultsOf the 470 patients assessed, 144 (30.6%) were at increased risk of VTE. Patients on old age wards were more likely to be at increased risk than those on general adult wards (odds ratio = 2.26, 95% CI 1.51–3.37). Of those at higher risk of VTE, auditors recorded concerns about prescribing prophylaxis in 70 patients (14.9%). Only 20 (4.3%) patients had a completed risk assessment.Clinical implicationsMental health in-patients are likely to be at increased risk of VTE. VTE risk assessment is not currently embedded in psychiatric in-patient care. There is a need for guidance specific to this population.

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Section: Discussionsupporting

confidence: 80%

“…VTE has an incidence of between 2 and 12% among psychiatric in-patients. 5,6 While psychiatric in-patients are often more mobile than those in acute hospital wards, there is evidence of psychiatry-specific risk factors. Case reports have linked VTE with both antipsychotic drugs 7–10 and physical restraint.…”

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confidence: 99%

Venous thromboembolism risk in psychiatric in-patients: a multicentre cross-sectional study

et al. 2019

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“…The level of daily life independence level in older adults with dementia was a significant DVT‐related factor in the present study. Although no previous study has assessed the relevance of ADL and DVT, some have suggested that cognitive impairment and poor physical activity relate to each other and to the onset of DVT; for example, the incidence of VTE in patients aged >75 years with dementia was 12.5%, and they had a higher risk of developing DVT than those without dementia in a psychiatric hospital . Furthermore, the risk of developing DVT in a nursing home among patients with reduced mobility caused by factors other than cognitive impairment was half that among patients with dementia .…”

Section: Discussionmentioning

confidence: 99%

New score including daily life independence levels with dementia is associated with the onset of deep vein thrombosis in frail older adults

Nakanishi

Kanda

Kobata

et al. 2020

Geriatrics Gerontology Int

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Aim: The detailed risk factors of deep vein thrombosis (DVT) remain unknown, and no efficient tool to assess the risk of the development of DVT among older adults has been established. This study aimed to clarify the risk factors, including the level of daily life independence, and develop an assessment score for DVT in older patients. Methods:We recruited 252 patients aged ≧65 years with suspected deep vein thrombosis. Risk factors for deep vein thrombosis, cognitive impairment, laboratory data and level of daily life independence were analyzed to calculate the odds ratios for the onset of DVT with logistic regressions. The Himi score was generated with factors significantly related to DVT by adjusting the respective odds ratios. The discrimination accuracy of the Himi score associated with the onset of DVT was compared with those of conventional scores (Wells score, Padua score) based on the area under the receiver operating characteristic curve.Results: Low levels of daily life independence, D-dimer level >3.0 μg/mL, anticoagulant use, cancer and immobilization or symptoms of the lower limbs were associated with the onset of DVT. The discrimination accuracy of Himi scores composed of these related factors was significantly higher than those of the Wells and Padua scores.Conclusions: Achieving a better performance than did the Wells and Padua scores, the Himi score could be used to assess the risk of DVT in frail older adults. Geriatr Gerontol Int 2020; 20: 414-421.Logistic regression was used to validate risk markers in study patients, and to calculate the crude and adjusted OR for different risk markers for the onset of DVT. In addition, 95% confidence intervals (95% CI) were reported. In addition to age and sex, variables with a P-value of <0.05 in univariate logistic analysis were

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“…This study was conducted with participants in the TADEUS (ThromboseAsymptomatique DEtectées par Ultra-Sonographie) project, which was originally designed to estimate the incidence of venous thromboembolism (VTE) in hospitalized psychiatric patients, and to assess the risk factors for VTE in this specific population (Delluc et al, 2012). …”

Section: Methodsmentioning

confidence: 99%

Prevalence of antiphospholipid antibodies in psychiatric patients users and non‐users of antipsychotics

et al. 2013

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SummaryPast reports have suggested that antiphospholipid (aPL) antibodies may emerge as a response to antipsychotics treatment, as a high prevalence of aPL antibodies in antipsychotics users has been observed. However, no control group of non-medicated psychiatric patients was included in these reports. In a cross sectional study we determined the prevalence of aPL antibodies in 333 psychiatric inpatients. We compared the proportions of positive aPL antibodytests between users and non-users of antipsychotics with adjustments for potential confounders. The proportion of antipsychotics users carrying at least one aPL antibody ranged from 10Á8% to 27Á0% compared with 6Á8% to 27Á2% in non-users (P = 0Á24, P = 0Á24) depending on the method of detection of lupus anticoagulant (LA). The prevalence of LA detected by dilute Russell viper venom time or partial thromboplastin time-LA was not different between antipsychotics users and non-users (8Á1% vs. 5Á4%, P = 0Á53 and 18Á4% vs. 18Á2%, P = 0Á22), as well as the prevalence of IgM and IgG anti-b2-glycoprotein-I antibodies, IgM and IgG anti-cardiolipin antibodies(3Á8% vs. 2Á0%, P = 0Á75, 0Á0% vs. 0Á0%, P = not applicable, 1Á1 vs. 1Á4%, P = 0Á91, 2Á7% vs. 3Á4%, P = 0Á71). In conclusion, aPL antibodies were frequently found in patients with psychiatric diseases and no significant increase in the prevalence of aPL antibodies was observed in antipsychotics users.

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Incidence of venous thromboembolism in psychiatric units

Cited by 19 publications

References 17 publications

Venous thromboembolism risk in psychiatric in-patients: a multicentre cross-sectional study

Venous thromboembolism risk in psychiatric in-patients: a multicentre cross-sectional study

New score including daily life independence levels with dementia is associated with the onset of deep vein thrombosis in frail older adults

Prevalence of antiphospholipid antibodies in psychiatric patients users and non‐users of antipsychotics

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