Contributions
Abstract: PB2510
Type: Publication Only
Background
Venous thromboembolism and DVT is recognized as the most common cause of inpatient death in the west and there exists established guidelines to direct its management. The incidence of Deep Vein Thrombosis however has been traditionally considered low in Asia. There exists no definitive scientific explanation to this and recent data challenge this concept. The limited data on the prevalence of deep vein thrombosis in India is both conflicting and scarce. This information is important to sensitize health care professionals and influence treatment strategies. In identifying with this goal we analysed the inpatient burden of DVT from our centre.
Aims
We attempted to estimate the prevalence of DVT among inpatients in our tertiary care centre.
Methods
We conducted a retrospective analysis of patients hospitalized between January 2014 through December 2016 to our academic hospital with 700 beds. Patients with potential venous thromboembolism were identified as those who underwent duplex ultrasound and CT Pulmonary angiogram (CTPA) examinations during that period. The diagnosis was confirmed by a review of the patients’ inpatient records. Major bleed was defined as one requiring transfusions. Death and repeat thrombosis were defined as events.
Results
A total of 106074 patients were admitted in these period and184 examinations (duplex of the leg and CTPA) were done. Of these 26 patients were excluded (16- arterial thrombus and 10 – no details on type of thrombus) for this analysis. Characteristics of the included patients are detailed in table1. The prevalence of DVT was 158 of 106074 patients (0.15%). The median length of hospitalization was 10 (5-15) days. Four (2.6%) patients had a pulmonary embolism. While hospitalized and diagnosed with a DVT; 18 (11.4%) had undergone a major surgery; 25 (15.8%) patients were diagnosed with a malignancy; 16 (10.1%) were related to their central line and 11 (7%) patients were on pharmacological prophylaxis. A thrombosis workup was done in 10 (6.3%) patients and swelling of the leg was the major complaint in 91 (82.0 %). The patients [55 (45.8%)] were mostly treated by a Vitamin K antagonist bridged with a LMWH.Seven (4.4%) patients required an IVC filter or embolectomy. There was one documented history of major bleed (Upper gastrointestinal bleed) and 20 deaths. The Overall (OS) and Event-free survival (EFS) at one year were 83.2% ± 3.9% and 74.1% ± 5.0% respectively.
Conclusion
Our analysis supports the belief that the prevalence of DVT in the Indian setting is low. An underlying malignancy is the most commonly identifiable cause of a DVT. Major bleed post treatment and primary prophylaxis are infrequent in inpatients. Racial differences and low levels of suspicion with resulting investigations might account for this variation in prevalence. Multicentric ,prospective data collection along with biological studies within India is needed to establish and explain this difference.
Session topic: 35. Thrombosis and vascular biology & translational Research
Keyword(s): DVT, Prevalence
Abstract: PB2510
Type: Publication Only
Background
Venous thromboembolism and DVT is recognized as the most common cause of inpatient death in the west and there exists established guidelines to direct its management. The incidence of Deep Vein Thrombosis however has been traditionally considered low in Asia. There exists no definitive scientific explanation to this and recent data challenge this concept. The limited data on the prevalence of deep vein thrombosis in India is both conflicting and scarce. This information is important to sensitize health care professionals and influence treatment strategies. In identifying with this goal we analysed the inpatient burden of DVT from our centre.
Aims
We attempted to estimate the prevalence of DVT among inpatients in our tertiary care centre.
Methods
We conducted a retrospective analysis of patients hospitalized between January 2014 through December 2016 to our academic hospital with 700 beds. Patients with potential venous thromboembolism were identified as those who underwent duplex ultrasound and CT Pulmonary angiogram (CTPA) examinations during that period. The diagnosis was confirmed by a review of the patients’ inpatient records. Major bleed was defined as one requiring transfusions. Death and repeat thrombosis were defined as events.
Results
A total of 106074 patients were admitted in these period and184 examinations (duplex of the leg and CTPA) were done. Of these 26 patients were excluded (16- arterial thrombus and 10 – no details on type of thrombus) for this analysis. Characteristics of the included patients are detailed in table1. The prevalence of DVT was 158 of 106074 patients (0.15%). The median length of hospitalization was 10 (5-15) days. Four (2.6%) patients had a pulmonary embolism. While hospitalized and diagnosed with a DVT; 18 (11.4%) had undergone a major surgery; 25 (15.8%) patients were diagnosed with a malignancy; 16 (10.1%) were related to their central line and 11 (7%) patients were on pharmacological prophylaxis. A thrombosis workup was done in 10 (6.3%) patients and swelling of the leg was the major complaint in 91 (82.0 %). The patients [55 (45.8%)] were mostly treated by a Vitamin K antagonist bridged with a LMWH.Seven (4.4%) patients required an IVC filter or embolectomy. There was one documented history of major bleed (Upper gastrointestinal bleed) and 20 deaths. The Overall (OS) and Event-free survival (EFS) at one year were 83.2% ± 3.9% and 74.1% ± 5.0% respectively.
Conclusion
Our analysis supports the belief that the prevalence of DVT in the Indian setting is low. An underlying malignancy is the most commonly identifiable cause of a DVT. Major bleed post treatment and primary prophylaxis are infrequent in inpatients. Racial differences and low levels of suspicion with resulting investigations might account for this variation in prevalence. Multicentric ,prospective data collection along with biological studies within India is needed to establish and explain this difference.
Session topic: 35. Thrombosis and vascular biology & translational Research
Keyword(s): DVT, Prevalence