Prevention, treatment, and risk factors of deep vein thrombosis in critically ill patients in Zhejiang province, China: a multicenter, prospective, observational study

Abstract

Purpose The aim of this study is to investigate the prevention and treatment patterns of deep vein thrombosis (DVT) in critically ill patients and to explore the risk factors for DVT in people from Zhejiang Province, China. Materials and methods This study prospectively enrolled patients admitted in intensive care units (ICUs) of 54 hospitals from 09/16/2019 to 01/16/2020. The risk of developing DVT and subsequent prophylaxis was evaluated. The primary outcome was DVT occurrence during ICU hospitalisation. Univariate and multivariate logistic regression were performed to determine the risk factors for DVT. Results A total of 940 patients were included in the study. Among 847 patients who received prophylaxis, 635 (75.0%) patients received physical prophylaxis and 199 (23.5%) patients received drug prophylaxis. Fifty-eight (6.2%) patients were diagnosed with DVT after admission to the ICU, and 36 patients were treated with anticoagulants (all patients received low molecular weight heparin [LMWH]). D-dimer levels (OR = 1.256, 95% CI: 1.132–1.990), basic prophylaxis (OR = 0.092, 95% CI: 0.016–0.536), and physical prophylaxis (OR = 0.159, 95% CI: 0.038–0.674) were independently associated with DVT in ICU patients. The short-term survival was similar between DVT and non-DVT patients. Conclusions DVT prophylaxis is widely performed in ICU patients. Prophylaxis is an independent protective factor for DVT occurrence. The most common treatment of DVT patients is LMWH, although it might increase the rate of bleeding. Key messages This is the only multicenter and prospective study of DVT in ICUs in China. d -dimer levels were independently associated with DVT in ICU patients. Prophylaxis was an independent protective factor for DVT occurrence in ICU.

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

“…Studies on DVT in critically ill patients have been conducted since the 1980s, but explorations speci cally for sepsis are still inadequate [9,10]. The usefulness and effectiveness of current scales in assessing the risk of DVT are limited in patients with sepsis by the non-speci city of risk categories being used and the uniqueness of this population [11,12]. Both the Caprini and the Wells scores are initially developed for the evaluation of DVT in the general population, which may not be reliable in septic patients.…”

Modern thromboprophylaxis protocol based on guidelines applied in a respiratory intensive care unit: a single-center prospective cohort study

“…Research from Australia showed that early thromboprophylaxis was used in 74% patients within 24 h of ICU admission [ 9 ]. An observation study has reported that with the increase of the medical staff’s awareness of VTE prophylaxis in China, the VTE prophylaxis rate in ICUs was about 90.1% [ 27 ]. In the present study, the thromboprophylaxis rate in the ICU was 93.7%, which is relatively higher than that mentioned in previous literature.…”

The risk factors for deep venous thrombosis in critically ill older adult patients: a subgroup analysis of a prospective, multicenter, observational study

“…The results of a previous study by the authors [ 13 ] showed that D-dimer levels, basic prophylaxis, and physical prophylaxis were independently associated with DVT in ICU patients. The subgroup analysis of middle-aged and older adult patients in the present study showed that age, the use of analgesic/sedative/muscarinic drugs, D-dimer levels, and high Caprini risk score were independently associated with DVT.…”

“…In the present post hoc subgroup analysis of a prospective, multicenter, observational study, patients who were hospitalized in the ICU of 54 hospitals in Zhejiang Province (China) from September 16, 2019, to January 16, 2020, were enrolled [ 13 ]. The approval of the study was carried out by the Medical Ethics Committee of Zhejiang Hospital (2019-24 K), and all patients or their family members signed the written informed consent form prior to enrollment.…”