Low Rate of Intrahospital Deep Venous Thrombosis in Acutely Ill Medical Patients: Results From the AURELIO Study.
Acute Disease
Aged
Aged, 80 and over
Anticoagulants
/ therapeutic use
Female
Follow-Up Studies
Hospitals, University
/ statistics & numerical data
Humans
Incidence
Italy
/ epidemiology
Length of Stay
/ trends
Lower Extremity
/ blood supply
Male
Prospective Studies
Risk Factors
Secondary Prevention
/ methods
Ultrasonography, Doppler, Color
Venous Thrombosis
/ epidemiology
Journal
Mayo Clinic proceedings
ISSN: 1942-5546
Titre abrégé: Mayo Clin Proc
Pays: England
ID NLM: 0405543
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
09
04
2018
revised:
30
05
2018
accepted:
03
07
2018
entrez:
7
1
2019
pubmed:
7
1
2019
medline:
28
5
2019
Statut:
ppublish
Résumé
To evaluate the effect of hospitalization on deep venous thrombosis (DVT) rate by the cumulative incidence of DVT in the proximal venous tract of the lower limbs at admission and discharge. The AURELIO (rAte of venoUs thRombosis in acutEly iLl patIents hOspitalized in internal medicine wards) multicenter observational study was carried out in hospital-university internal medicine wards including consecutive acutely ill medical patients. Patients underwent compression ultrasonography (CUS) of proximal lower limb veins at admission and discharge. The occurrence of DVT was the primary end point of the study. Among 1340 patients, 26 (1.9%; 95% CI, 1.3%-2.8%) had asymptomatic DVT at admission and were excluded. During the follow-up, 144 patients were excluded because of hospitalization less than 5 days. The remaining 1170 patients underwent a CUS at discharge. Two hundred fifty (21%) underwent prophylaxis with parenteral anticoagulants; the remaining 920 (79%) were not treated with anticoagulants. The mean length of hospitalization was 13±8 days. Compared with patients without prophylaxis, those treated with parenteral anticoagulants had a higher incidence of active cancer, heart and respiratory failure, pneumonia, renal failure, previous venous thromboembolism, reduced mobility, and elderly age. During the hospital stay, 3 patients with a negative CUS at admission experienced DVT in the proximal tract (0.025%, rate of 1 per 5017 patient-days); 2 of them were in prophylaxis with parenteral anticoagulants. We provide evidence that in the real world acutely ill medical patients display more than 90% (1.9%) asymptomatic DVT at admission, whereas the intrahospital DVT occurrence is very low. This suggests a novel diagnostic workup and a careful reanalysis of anticoagulant prophylaxis.
Identifiants
pubmed: 30611451
pii: S0025-6196(18)30662-1
doi: 10.1016/j.mayocp.2018.07.020
pii:
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
37-43Investigateurs
Stefania Basili
(S)
Pasquale Pignatelli
(P)
Domenico Ferro
(D)
Elisabetta Rossi
(E)
Marco Antonio Casciaro
(MA)
Lohengrin Stefania Pirillo
(LS)
Ilaria Maria Palumbo
(IM)
Arianna Pannunzio
(A)
Ludovica Pesci
(L)
Lorenzo Baldini
(L)
Pier Luigi Meloni
(PL)
Assunta Sauchella
(A)
Sara Melis
(S)
Maria Berria
(M)
Maurizio Cringoli
(M)
Deborah Blanca
(D)
Francesco Casella
(F)
Evaristo Ettorre
(E)
Mauro Cacciafesta
(M)
Alberto Vegetti
(A)
Andrea Crociani
(A)
Emilia Donnarumma
(E)
Giulia Pacciani
(G)
Rossella Rovereto
(R)
Sarah Lunardi
(S)
Antonella Tufano
(A)
Veronica Pacetti
(V)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.