Home > Riviste > International Angiology > Fascicoli precedenti > Articles online first > International Angiology 2020 Nov 20

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi PROMO
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

 

International Angiology 2020 Nov 20

DOI: 10.23736/S0392-9590.20.04528-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Calf deep vein thrombosis: frequency, therapeutic management, early outcomes and all-causes mortality in a cohort of hospitalized patients

Giovanna ELMI 1 , Leonardo ALUIGI 2, Davide ALLEGRI 3, Elisa R. RINALDI 1, Valeria CAMAGGI 1, Rosella DI GIULIO 1, Alberto MARTIGNANI 1, Maria Letizia BACCHI REGGIANI 4, Andrea DOMANICO 1, Pier Luigi ANTIGNANI 5

1 Ultrasound Program, Medical Department, Maggiore Hospital, AUSL Bologna, Bologna, Italy; 2 Angiology Unit, Clinica Privata Villalba, Bologna, Italy; 3 Department of Clinical Governance and Quality, Bologna Local Healthcare Authority, Bologna, Italy; 4 DIMES - Specialistic, Diagnostic and Experimental Medicine Department, University of Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Bologna, Italy; 5 Vascular Centre, Nuova Villa Claudia, Roma, Italy


PDF


BACKGROUND: isolated distal deep vein thromboses (IDDVT) are frequent; however, their optimal management is still controversial.
METHODS: we performed a retrospective study on inpatients undergoing ultrasound for suspected deep vein thrombosis (DVT) or with a particular risk profile, during 2016. The study was aimed to assess the frequency of proximal deep vein thromboses (PDVT) and IDDVT; to evaluate therapeutic management and identify variables associated with early outcomes and mortality among IDDVT patients; to compare all-causes mortality between subjects with PDVT and IDDVT.
RESULTS: among 21594 patients hospitalized in the study period 251 IDDVT and 149 PDVT were diagnosed; the frequency was 1.2 % and 0.7% respectively. 19% of IDDVT patients died compared to 25,5% of PDVT subjects (OR 0.72; 95% CI 0.44-1.17; p 0.19). In IDDVT patients, age ≥ 80, cancer and intracranial bleeding increased the risk of death (OR 2; 95% CI 1.07-3.75, p 0.001; OR 8.47; 95% CI 3.28-21.88, p 0.0000003; OR 2.33; 95% CI 1.18-4.58, p 0.0003). A significant association between intracranial hemorrhage and both proximal extension by using the Fisher’s exact test (p 0.031; OR 16.11; 95% CI 0.80-321.2), and composite of propagation to popliteal or to other calf veins (OR 8.28, 95% CI 2.07-33 p 0.001) was observed. Standard anticoagulation significantly reduced the composite of propagation to popliteal or to other calf veins (OR 0.07; 95% CI 0.009-0.61, p 0.007), and all-causes mortality (OR 0.37; 95% CI 0.17-0.8; p 0.02), without a significant increase of bleeding.
CONCLUSIONS: among inpatients, IDDVT exceeded 60% of DVT. Mortality was not significantly different between IDDVT and PDVT subjects. Intracranial bleeding significantly increased the risk of propagation and death. Although standard anticoagulation decreased both these complications, further targeted studies are needed.


KEY WORDS: Deep vein thrombosis; Duplex ultrasound; Anticoagulation; Calf deep vein thrombosis; Bleeding

inizio pagina