Original ArticlesPrevalence, incidence, and risk factors for venous thromboembolism in medical-surgical intensive care unit patients
Section snippets
Some methodological considerations when interpreting prevalence and incidence data
An assessment of the incidence and prevalence of venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), in medical-surgical intensive care unit (ICU) patients is based on 3 premises. First, although PE is the main thromboembolic outcome of interest, because it confers an increased risk of morbidity and mortality, no studies have systematically assessed the incidence or prevalence of this complication in ICU patients [1]. Consequently, DVT is used as
Risk factors for DVT in medical-surgical ICU patients
Established risk factors for DVT can be categorized as clinical risk factors, congenital hypercoagulable states, and acquired hypercoagulable states.
Summary
In medical-surgical ICU patients who do not receive DVT prophylaxis, the incidence of clinically important proximal DVT occurring during their ICU stay is between 25% and 32%, whereas the risk is, at most, between 10% and 18% in patients who receive prophylaxis. These data place medical-surgical ICU patients at lower risk for DVT compared with acute spinal cord injury, trauma, or neurosurgery patients, at comparable risk to patients who have had major orthopedic surgery, and at higher risk than
References (37)
- et al.
The incidence of deep venous thrombosis in ICU patients
Chest
(1997) - et al.
Screening for asymptomatic deep vein thrombosis in surgical intensive care patients
J Vasc Surg
(1997) - et al.
The radiological investigation of suspected lower limb deep vein thrombosis
Clin Radiol
(1997) - et al.
A common genetic variation in the 3′-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis
Blood
(1996) - et al.
Septic shock, multiple organ failure, and disseminated intravascular coagulation: compared patterns of antithrombin III, protein C, and protein S deficiencies
Chest
(1992) - et al.
Deep venous thrombosis and its prevention in critically ill adults
Arch Intern Med
(2001) - et al.
Prevalence of deep venous thrombosis among patients in medical intensive care
JAMA
(1995) - et al.
Noninvasive diagnosis of deep venous thrombosis. McMaster diagnostic imaging practice guidelines initiative
Ann Intern Med
(1998) - et al.
Deep venous thrombosis: recent advances and optimal investigation with ultrasound
Radiology
(1999) - et al.
Natural history of postoperative deep-vein thrombosis
Lancet
(1969)
Prevalence of deep-venous thrombosis of the leg in patients with acute exacerbations of chronic obstructive pulmonary disease
Respiration
Predictive value of a rapid semiquantitative d-dimer assay in critically ill patients with suspected venous thromboembolic disease
Crit Care Med
Deep venous thrombosis and pulmonary embolism: frequency in a respiratory intensive care unit
JAMA
Deep vein thrombosis during prolonged mechanical ventilation despite prophylaxis
Crit Care Med
Deep venous thrombosis in medical-surgical ICU patients: prevalence, incidence and risk factors
Crit Care Med
A prospective study of venous thromboembolism after major trauma
N Engl J Med
A rapid assay for the detection of circulating d-dimer is associated with clinical outcomes among critically ill patients
Crit Care Med
Prevalence of factor V Leiden in a Canadian blood donor population
CMAJ
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