PURPOSE: To determine the incidence of lower extremity DVT by Doppler venous ultrasound (LE Duplex Scan) among Filipino patients admitted to a medical-surgical ICU at a tertiary referral medical center and to determine its risk factors.
METHODS: From June to August 2009, all adult Filipino patients admitted to the ICU with a minimum 4-day ICU stay and who were not on full anticoagulation were included. LE Duplex Scan was done between the 4th and 7th day of ICU stay. Clinical data including demographics, APACHE II score, co-morbid conditions and risk factors were recorded. Univariate and multivariate regression analysis were done to determine relationships between the clinical data and the incidence of DVT. A p < .05 was considered significant.
RESULTS: One hundred thirty four ICU patients were admitted in the study period but only 94 fulfilled the inclusion criteria. Of these, 12 were excluded due to absence of consent (n=4), death (n=4) and transfer out of the ICU (n=4) before LE Duplex scan could be done. Of the remaining 82 patients, 20.7% (n=17) tested positive for DVT. Univariate analysis identified the presence of cancer (53% vs. 12%, difference of 31%, p=.001) and the use of mechanical ventilator (88% vs 49%, difference of 39%, p=.004) as the only significant predictor of DVT. Multivariate regression analysis identified the presence of cancer (OR 19.7; p=0.001), use of mechanical ventilator (OR 12.08; p=0.019), and high BMI (OR 1.2; p= 0.008) to be predictive of DVT.
CONCLUSION: The incidence of DVT in Filpino patients in our ICU is 20.7%. Patients with cancer, a high BMI and who were on a mechanical ventilator were found to be significantly at risk for DVT.
CLINICAL IMPLICATIONS: Several studies have suggested that DVT and PE are uncommon among Asians. Currently, DVT prophylaxis is not routinely done. This study shows a high incidence of DVT in Filipinos. Routine DVT prophylaxis is indicated in the ICU especially if the patient has cancer, on a mechanical ventilator or has a high BMI.
DISCLOSURE: Jun Maximo Lasco II, No Financial Disclosure Information; No Product/Research Disclosure Information