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The Incidence of Deep Venous Thrombosis in ICU Patients

Paul E. Marik; Lynn Andrews; Baltej Maini
Author and Funding Information

Affiliations: From the Department of Critical Care Medicine, St. Vincent Hospital, The Fallon Clinic, and the University of Massachusetts Medical School, Worcester,  From the Department of Surgery, St. Vincent Hospital, The Fallon Clinic, and the University of Massachusetts Medical School, Worcester

Affiliations: From the Department of Critical Care Medicine, St. Vincent Hospital, The Fallon Clinic, and the University of Massachusetts Medical School, Worcester,  From the Department of Surgery, St. Vincent Hospital, The Fallon Clinic, and the University of Massachusetts Medical School, Worcester


1997 by the American College of Chest Physicians


Chest. 1997;111(3):661-664. doi:10.1378/chest.111.3.661
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Abstract

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 ≥4 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.


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