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Acta Phlebologica 2017 April;18(1):22-8

DOI: 10.23736/S1593-232X.17.00387-3


lingua: Inglese

Prevention and treatment of venous thrombosis with therapeutic elastic tutors in different care settings. Clinical and hemodynamic evaluation and assessment of compliance to different treatments

Gabriella M. SPEZZIGU 1, Massimo MILANI 1, Aladar IANES 2, Guido G. ARPAIA 3

1 Unit of Medical Angiology and Non-Invasive Vascular Diagnosis, Desio and Vimercate Hospital, Desio, Monza-Brianza, Italy; 2 Korian, Milan, Italy; 3 Internal Medicine Division, Carate Brianza Hospital-ASST Vimercate, Carate Brianza, Monza-Brianza, Italy


BACKGROUND: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are two distinct but related features of venous thromboembolism (VTE) which is a single pathological process. VTE is the most frequent, though also the most easily preventable, cause of in-hospital deaths. Current tendencies to discharge patients promptly, the aging of the population - which raises the numbers with multiple pathologies and frailty - and the increasing habit of transferring patients to postacute or chronic care facilities may affect the risk of VTE and its prophylaxis. Risk factors related to thromboembolic risk, associated with long-term residential care, seem therefore at least partly independent of the traditional risk factors, and are still not clearly defined.
METHODS: The study was divided into two stages. During the first stage, lasting nine months, we examined the incidence of new cases of symptomatic or asymptomatic DVT by clinical examination and ultrasound at the bedside. The second stage, lasting about 15 months, was the intervention stage. The population at risk was divided into two groups, one receiving antithrombotic treatment using ATE hose, the second one represented the control group. To all patients was applied a risk nomogram previously published by our group.
RESULTS: About the patients included in the first phase of the study, we founded only three cases of venous thrombosis (two superficial and one deep) with a prevalence of 4%. During the second phase of the study no one developed venous thromboembolism. More than 50% of the patients showed a low thromboembolism risk applying our nomogram.
CONCLUSIONS: In our study population the prevalence and incidence of VTE were lower than expected, confirming the nomogram risk analysis. This is probably because many patients kept a fair degree of mobility, and also thanks to an assiduous nursing support. Antithromboembolic stockings showed no adverse reactions (malpositioning, decubitus).

KEY WORDS: Venous thrombosis - Prevention and control - Stockings, compression - Long-term care

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