Prevalence of deep vein thrombosis (DVT) in non-surgical patients at hospital admission

Holger Lawall; Wibke Hoffmanns; Phillip Hoffmanns; Uli Rapp; Michael Ames; Alessandro Pira; Dieter W. Paar; Peter Bramlage; Curt Diehm

doi:10.1160/TH07-02-0107

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2007; 98(04): 765-770
DOI: 10.1160/TH07-02-0107

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Prevalence of deep vein thrombosis (DVT) in non-surgical patients at hospital admission

Authors

Holger Lawall

¹Department of Internal Medicine/Vascular Medicine, Hospital Karlsbad-Langensteinbach, Affiliated Teaching Hospital, University of Heidelberg, Karlsbad, Germany
Wibke Hoffmanns

¹Department of Internal Medicine/Vascular Medicine, Hospital Karlsbad-Langensteinbach, Affiliated Teaching Hospital, University of Heidelberg, Karlsbad, Germany
Phillip Hoffmanns

¹Department of Internal Medicine/Vascular Medicine, Hospital Karlsbad-Langensteinbach, Affiliated Teaching Hospital, University of Heidelberg, Karlsbad, Germany
Uli Rapp

¹Department of Internal Medicine/Vascular Medicine, Hospital Karlsbad-Langensteinbach, Affiliated Teaching Hospital, University of Heidelberg, Karlsbad, Germany
Michael Ames

¹Department of Internal Medicine/Vascular Medicine, Hospital Karlsbad-Langensteinbach, Affiliated Teaching Hospital, University of Heidelberg, Karlsbad, Germany
Alessandro Pira

¹Department of Internal Medicine/Vascular Medicine, Hospital Karlsbad-Langensteinbach, Affiliated Teaching Hospital, University of Heidelberg, Karlsbad, Germany
Dieter W. Paar

²Sanofi-Aventis Deutschland GmbH, Medical Affairs, Berlin, Germany
Peter Bramlage

³Institute for Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technical University Dresden, Germany
Curt Diehm

¹Department of Internal Medicine/Vascular Medicine, Hospital Karlsbad-Langensteinbach, Affiliated Teaching Hospital, University of Heidelberg, Karlsbad, Germany

Abstract

Summary

Venous thromboembolism (VTE) is known as a common complication in surgical and non-surgical patients. We hypothesized that according to the underlying risk factors and the acute illness, the prevalence of VTE in non-surgical patients admitted to hospital is widely underestimated. For three months each patient admitted to the department of internal medicine with an acute illness, but without known deep venous thrombosis (DVT) was investigated by ultrasound compression sonography. Patients’ history, risk factors and extent of immobilisation were documented. In patients with newly detected DVT D-dimer and fibrinogen were measured as well as computer tomography scans performed. Follow-up investigations of the DVT population were performed at four weeks and three months. Six hundred seventeen patients (49.3% men) were included. In 16 patients (men=7) a previously unknown thrombosis (2.6%) was detected, mainly in patients with acute cardio-pulmonary disease (56%) and the elderly (mean age 75.6 years). Eight patients had femoro-popliteal (50.0%), four a femoral (25.0%), and four a popliteal vein thrombosis (25.0%). Five had pulmonary embolism (31.3%). In patients with DVT D-dimer was 875 ± 1,228 mg/l, fibrinogen 568 ± 215 mg/dl and C-reactive-protein 58.54 ± 73.65 mg/dl. One patient died from sepsis during hospitalisation, one died from sudden cardiac death at home. None of the other 14 surviving patients relapsed. The study shows a 2.6% risk for DVT in outpatients with acute illness admitted to the department of internal medicine. These data demonstrate the high risk of DVT is in non-surgical patients. Early prophylaxis has to be considered in internal medicine patients especially in the elderly.

Keywords

Venous thromboembolism - prevalence - medical patients - deep venous thrombosis - ultrasonography

Full Text

References

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