Analysis Of Clinical Characteristics In 275 Hospitalized Patients With Venous Thromboembolism

Objective To Analysis the clinical characteristics of venous thromboembolism(VTE) in hospitalized patients, especially in postoperative patients. And to provide a VTE epidemiological evidence to clinic.Methods Collected the clinical data of patients with VTE at The First Affiliated Hospital of Soochow University during Nov.2006 and Jan.2011. To analysis the VTE clinical characteristics including annual incidence rate, age and sex constituent ratio,clinical subtype, risk factors, clinical presentation and fatality rate. Further to investigate the Surgical departments distribution, high-risk-operation types, postoperative time of high incidence and the outcomes of the postoperative VTE patients. Relative risk of VTE and PTE related to age between operative patients with nonoperative patients was compared. Chi-Square Test and Logistic Regression were taken to deal with the date with SAS V8.1 statistical software.Results①There were totally 275 patients with VTE at The First Affiliated Hospital of Soochow University during Nov.2006 and Jan.2011, including 223 DVT (204 simple DVT plus 68 DVT complicated with PTE) and 71 PTE (52 simple PTE plus 19 DVT complicated with PTE). Among them, there were 78 postoperative patients who suffered to VTE, including 68 DVT (64 simple DVT plus 4 DVT complicated with PTE) and 14 PTE (10 simple PTE plus 4 DVT complicated with PTE).②The annual incidence rate of VTE in hospitalized patients and postoperative patients were increasing year by year from 2007 to 2010. There was a higher incidence rate of VTE at the age zone range from 40 to 79.③The fatality rate of PTE in hospitalized patients and in postoperative patients was 21.1% and 64.3% respectively.④As for the risk factors of VTE, DVT and PTE in 275 hospitalizde patients, the top three risk factors of VTE and DVT were the chronic cardiovascular diseases(31.6%,32.3%), undergoing surgery recently (28.4%, 30.5%), malignant tumor (13.8%,16.1%), and the top three risk factors of PTE were cardiovascular diseases(32.4%), smoke(32.4%), undergoing surgery recently(19.7%).⑤The common three clinical characteristics of PTE were hard breath (88.8%),cough (35.2%) and heart rate increase (35.2%). The common clinical presentation of DVT was lower limb swelling and pain.⑥The two higher incidence rate surgical departments of VTE,DVT and PTE were orthopedic surgery and Cardiovascular surgery, the two lower of VTE and DVT were neurosurgery and urology, and the two lower of PTE were thoracid surgery and general surgery. There was a significant difference between the higher and lower incidence rate surgical departments (P<0.05).⑦The five high-risk-operation types related to VTE were gastrointestinal cancer operation (15.4%), cesarean section(10.3%), femoral neck fracture operation(7.7%),vertebral fracture operation (6.4%),urological malignancies operation (5.1%).⑧There were 82.4% patients with DVT and 85.7% patients with PTE occurred within 30 days after surgery.7-9 days and 28-30 days after surgery were the two time points of high incidence of DVT and PTE.⑨The relative risk of DVT and PTE of 80-99 year old postoperative patients was 1.62,2.16 times to nonoperative patients respectively.Conclusion The annual incidence rates of VTE in hospitalized patients and postoperative patients are increasing year by year. Patients aged from 40 to 79 years are easy to suffer VTE in hospital. The outcomes of PTE is miserable, and the fatality rate of PTE in postoperative patients is worse. The top three risk factors of VTE and DVT are the chronic Cardiovascular diseases, undergoing surgery recently and cancer. The top three risk factors of PTE are Cardiovascular diseases, smoke, undergoing surgery recently. The common clinical presentations of PTE include hard breath, cough, heart rate increase. The most common presentation of DVT is lower limbs swelling and pain. The top two Surgical departments of incidence rate of VTE,DVT and PTE are orthopedic surgery and Cardiovascular surgery. The high-risk-operation types related to VTE are gastrointestinal cancer operation, cesarean section, femoral neck fracture operation,vertebral fracture operation and urological malignancies operation. Most of VTE postoperative patients occurr within 30 days after surgery.