The Incidence And Risk Factors Of Deep Vein Thrombosis In Surgical Critically Ill Patients

ObjectiveCritically ill patients may be at high risk of venous thromboembolism.The objective was to determine the incidence and risk factors for lower extremity deep vein thrombosis(DVT) among surgical critically ill patients.MethodsWe enrolled 79 consecutive patients who were admitted to surgical intensive care unit from October 2007 to March 2008 in Zhongshan hospital.We collected demographic data including patients' age,gender,height,weight,history of medical diseases,et al.And obtained APACHEⅡscores within the first 24 hours after patients were admitted.We conducted bilateral lower extremities compression ultrasound to determine the presence of DVT,and lack of compressibility of one or more venous segments was the diagnostic criterion for DVT.We performed the first scan within 48 hours of patients admission to the SICU,and once a week after if the first result was negative till lower extremities DVT were diagnosed.Patients were followed to death or SICU discharge.We documented special treatment procedures including mechanical ventilation, administration of vasopressors,hemodialysis and length of stay in SICU.We also collected certain biochemical assays results.The data was compared statistically with chi square test and t-test between those who found DVT and no DVT.ResultsAmong 79 patients,we found 14 had DVT in whom 3 were proximal DVT and 13 were distal DVT.Two patients had both proximal and distal DVT.Of the 14 patients who had DVT compared with those who didn't diagnose DVT, we got a conclusion:BMI 24.9±3.5(p=0.02),APACHEⅡscore 19.9±3.7(p=0.009), history of diabetes mellitus 28.6%(p=0.03),underwent vessel surgeries patients 28.6%(p=0.012).11 patients required mechanical ventilation(78.6%,p＜0.01) and 10 required use of vasopressors(71.4%,p＜0.01) among 14 DVT patients.Those who diagnosed DVT had an average stay in SICU for 25.7±27.7 day,with 28.6%death rate.Compared with those who didn't have DVT,p value was＜0.001 and 0.048 respectively.ConclusionSurgical-critically ill patients have more risk factors of venous thromboembolism, thus leading to a higher incidence.Obesity,severity of disease(APACHEⅡscore), mechanical ventilation,use of vasopressors are risk factors of DVT.On the other hand, presence of DVT significantly increase mortality and duration of ICU stay among critically ill patients.