The incidence of deep venous thrombosis in ICU patients

被引:107
作者
Marik, PE
Andrews, L
Maini, B
机构
[1] FALLON CLIN INC, ST VINCENT HOSP, DEPT CRIT CARE MED, WORCESTER, MA USA
[2] FALLON CLIN INC, ST VINCENT HOSP, DEPT SURG, WORCESTER, MA USA
[3] UNIV MASSACHUSETTS, SCH MED, WORCESTER, MA USA
关键词
deep venous thrombosis; ICU; prevalence; prophylaxis; pulmonary embolus; ultrasonography;
D O I
10.1378/chest.111.3.661
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Study objective: To determine the incidence, clinical presentation, and risk factors of deep venous thrombosis (DVT) in a high-risk group of ICU patients receiving DVT prophylaxis. Design: A prospective cohort study. Setting: Two ICUs of a university-affiliated teaching hospital. Patients: Patients admitted to the ICUs within 48 h of hospitalization and who had an ICU stay of 14 days underwent venous duplex scans. Interventions: None. Results: One hundred two patients were studied. Ninety-four (92%) patients received DVT prophylaxis. Twelve patients (12%) were documented-to have DVT by venous duplex scans. There was proximal clot extension in eight of these patients, four of whom had high-probability ventilation/perfusion scans. Of the 56 patients without signs or symptoms of DVT, only two (3.6%) had abnormal scans. Leg swelling was present in 11 patients, six of whom had DVT (p=0.004). One of 11 patients with unexplained fever had an abnormal scan. Five of the 26 patients (19%) receiving pneumatic compression developed DVT compared with five of 68 patients (7.4%) receiving subcutaneous heparin (not significant). No specific factor was identified that increased the risk of DVT. Conclusion: In this study, the incidence of DVT in a group of high-risk ICU patients receiving DVT prophylaxis was 12%. Since scans in patients without signs or symptoms suggestive of DVT were abnormal in only 3.6% of patients, venous scans should be performed only in patients with features suggestive of DVT or pulmonary embolism.
引用
收藏
页码:661 / 664
页数:4
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