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The Prognostic Value of Impaired Walking Distance on Long-term Outcome in Patients with Known or Suspected Peripheral Arterial Disease
Authors:I.I. de Liefde   S.E. Hoeks   Y.R.B.M. van Gestel   J. Klein   J.J. Bax   H.J.M. Verhagen   R.T. van Domburg  D. Poldermans  
Affiliation:aDepartment of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands;bDepartment of Cardiology, Erasmus MC, Rotterdam, The Netherlands;cDepartment of cardiology, LUMC, Leiden, The Netherlands;dDepartment of Vascular Surgery Anaesthesiology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
Abstract:
IntroductionVenous thrombo-embolism (VTE) has traditionally been considered rare in Asia. Recent reports from Hong Kong and Singapore indicate an increasing incidence of VTE.ObjectivesTo determine the incidence of VTE among hospitalised patients and study the predisposing factors and hence to increase the awareness of the need for VTE prophylaxis.MethodsThis is a retrospective study carried out on all patients diagnosed with VTE between 1996 and 2005 at our hospital. In-patient records were used to collect data while out-patient records were used for follow-up outcomes.ResultsThe incidence of VTE was 17.46 per 10 000 admissions. Malignancy (31%) was the most common predisposing factor, followed by postoperative status (30%). The incidence following surgery was five per 10 000 operations. General surgery patients had the highest incidence of deep vein thrombosis (DVT; 40.3%), while the incidence in orthopaedic patients was 20.1%. Low-molecular-weight heparin (LMWH) has been increasingly used therapeutically over the years. Pulmonary embolism was diagnosed in 14.9% of the study patients. Mortality in those with confirmed pulmonary embolism was 13.5%.ConclusionVTE is no longer a rarity in India. General surgical operations are the most common causes of postoperative DVT. Pulmonary embolism continues to be ‘suspected’ more often than it is diagnosed.
Keywords:Walking   Peripheral artery disease   Ankle–  brachial index   Exercise test   Mortality   Cardiac death
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