Venous thrombosis of the lower limbs with particular reference to bed-rest

Gibbs, N. M.

doi:10.1002/bjs.18004519102

Cited by 358 publications

(129 citation statements)

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“…16) Gibbs reported that VTE occurred with high frequency when the duration of bed rest was more than one week. 17) Flordal et al reported that long hospital stay was independent predictor for major thromboembolism. 18) From the study results reported by Gibbs and Flordal et al, 17,18) long term bed rest was shown as a moderate risk for VTE in Japanese prevention guideline.…”

Section: Resultsmentioning

confidence: 99%

“…17) Flordal et al reported that long hospital stay was independent predictor for major thromboembolism. 18) From the study results reported by Gibbs and Flordal et al, 17,18) long term bed rest was shown as a moderate risk for VTE in Japanese prevention guideline. 14) ACCP guideline showed that favored strategy for diagnosis of first DVT was combine use of pretest probability assessment, D-dimer, and ultrasonography.…”

Section: Resultsmentioning

confidence: 99%

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Occurrence of Deep Vein Thrombosis among Hospitalized Non-Surgical Japanese Patients

Yamada

Hanzawa

Ota

et al. 2015

Annals of Vascular Diseases

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Objective: To estimate the frequency of deep vein thrombosis (DVT) among non-surgical inpatients, and to evaluate the D-dimer assay as a screening tool for DVT. Methods: Subjects were non-surgical inpatients aged 20 years or older who had been bedridden for at least 24 hours and had moderate-to-high risk factors for DVT. We assessed the presence of DVT by venous ultrasonography. Patients who received a diagnosis of venous thromboembolism (VTE) before admission, who had symptoms or findings of VTE at admission, or who had surgery or trauma within the past 3 months before admission were excluded. Results: DVT was confirmed in 96 of 525 patients (18.3%). In a logistic regression analysis, longer duration of hospitalization, higher D-dimer value, and history of cancer surgery were significantly associated with the occurrence of DVT. The D-dimer assay showed high sensitivity (96.1%) and high negative predictive value (97.6%). Conclusion: Non-surgical inpatients with a long-term hospitalization or history of cancer surgery have a risk for DVT, and need to be considered for added DVT preventive measures as recommended in the prevention guidelines. In addition, the D-dimer assay is beneficial for the screening of DVT in medical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Occurrence of Deep Vein Thrombosis among Hospitalized Non-Surgical Japanese Patients

Yamada

Hanzawa

Ota

et al. 2015

Annals of Vascular Diseases

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“…[3][4][5][6] Other important risk factors include immobilisation, hospitalisation, malignancy, previous VTE, and comorbidities such as heart failure, stroke, chronic obstructive pulmonary disease (COPD), and diabetes mellitus. [7][8][9][10][11][12][13][14] Approximately 50% of VTE is associated with hospital admission, and VTE risk assessment of hospitalised patients is strongly recommended by evidence-based guidelines. 15 It could be argued that care home residents have VTE risk profiles similar to those of medical inpatients, 16,17 although the impact of VTE risk factors in the UK care home population is unknown.…”

Section: Introductionmentioning

confidence: 99%

Incidence of venous thromboembolism in care homes: a prospective cohort study

et al. 2017

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BackgroundCare home residents have venous thromboembolism (VTE) risk profiles similar to medical inpatients; however, the epidemiology of VTE in care homes is unclear.AimTo determine the incidence of VTE in care homes.Design and settingObservational cohort study of 45 care homes in Birmingham and Oxford, UK.MethodA consecutive sample of care home residents was enrolled and followed up for 12 months. Data were collected via case note reviews of care home and GP records; mortality information was supplemented with Health and Social Care Information Centre (now called NHS Digital) cause of death data. All potential VTE events were adjudicated by an independent committee according to three measures of diagnostic certainty: definite VTE (radiological evidence), probable VTE (high clinical indication but no radiological evidence), or possible VTE (VTE cannot be ruled out). (Study registration number: ISTCTN80889792.)ResultsThere were 1011 participants enrolled, and the mean follow-up period was 312 days (standard deviation 98 days). The incidence rate was 0.71 per 100 person years of observation (95% confidence interval [CI] = 0.26 to 1.54) for definite VTE, 0.83 per 100 person years (95% CI = 0.33 to 1.70) for definite and probable VTE, and 2.48 per 100 person years (95% CI = 1.53 to 3.79) for definite, probable, and possible VTE.ConclusionThe incidence of VTE in care homes in this study (0.71–2.48 per 100 person years) is substantial compared with that in the community (0.117 per 100 person years) and in people aged ≥70 years (0.44 per 100 person years). Further research regarding risk stratification and VTE prophylaxis in this population is needed.

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“…A recent study showed that for 2000 DVT patients with age-matched spouses, the probability of developing DVT after being stationary in a plane, train, or car for more than four hours was increased more than two-fold (6). Other types of immobility such as paralysis, bed rest, or even prolonged computer use have also been shown to increase the risk of thrombosis (7)(8)(9)(10). There are many different causes for DVT (11) but blood stasis appears to be the most important (12).…”

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confidence: 99%

Settling properties of venous blood demonstrated in the peripheral vasculature using susceptibility‐weighted imaging (SWI)

Barnes

Haacke

2009

Magnetic Resonance Imaging

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Purpose: To evaluate the settling properties of venous blood in the peripheral vasculature during periods of immobility. Materials and Methods:Susceptibility-weighted imaging (SWI) was performed for nine subjects at two time points: within 10 minutes of entering the magnet and after 40 minutes spent stationary in the magnet. Changes in the phase and in the distribution of phase of the veins were used to draw conclusions about the separation of red blood cells from plasma over time.Results: Settling was observed to occur in eight of the nine subjects, the only exception being the youngest subject (18 years old). The bottom half of some veins was seen to darken while the top half showed little change often with a clear dividing line between the two. Phase values measured in the bottom layer were consistent with the layer consisting entirely of red blood cells. Settling was seen to increase with time spent stationary and to correlate with the size of veins in the calf. Conclusion:Older subjects tended to have larger veins and consequently more settling of the red blood cells. Our results show that even 40 minutes of rest can easily lead to settling of the blood depending on the position of the leg.

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Venous thrombosis of the lower limbs with particular reference to bed-rest

Cited by 358 publications

References 29 publications

Occurrence of Deep Vein Thrombosis among Hospitalized Non-Surgical Japanese Patients

Occurrence of Deep Vein Thrombosis among Hospitalized Non-Surgical Japanese Patients

Incidence of venous thromboembolism in care homes: a prospective cohort study

Settling properties of venous blood demonstrated in the peripheral vasculature using susceptibility‐weighted imaging (SWI)

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