Deep venous thrombosis in elderly hospitalized patients: prevalence and clinical features

BACKGROUND AND AIMS: It is not known whether old age influences the clinical outcome of deep venous thrombosis (DVT) in patients admitted to acute internal medicine wards. This study aimed at evaluating the effect of age on the prevalence and clinical features of DVT in patients admitted to acute medical wards in a general hospital. METHODS: All patients with a discharge diagnosis of DVT during a 4-year period from 1999 to 2002 were identified. Age, gender, main and secondary diagnoses, diagnostic procedures, and length of stay (LOS) were recorded. The severity index was calculated by the All Patients Refined-Diagnostic Related Groups (APR-DRG) grouper and graded as mild, moderate, severe or extreme. RESULTS: 310 patients with DVT were identified: 163 males and 147 females. Mean age was 62 +/- 16 years, with a range of 17-94 years. 174 patients (56%) were over 65 years old (mean age = 74.2 +/- 6.2, range 65-94 years) and 136 (44%) were young or adults (mean age = 48.3 +/- 12.9, range 17-64 years). The overall prevalence of DVT was 1.51%, with no differences between males and females (1.46 vs 1.56%, p = NS). In elderly subjects, the prevalence of DVT was significantly higher than in young or adult patients (1.7 vs 1.2%, p = 0.005) and was more frequently associated with pulmonary embolism (12 vs 7%, p < 0.05) and less with neoplasms (10 vs 30%, p < 0.05) than in young patients. Diagnostic procedures performed during the hospital stay were similar for elderly and young patients whereas LOS was significantly longer in elderly than young patients (14.1 +/-11.5 vs 11.7 +/- 9 days, p < 0.05). The APR-DRG severity index was significantly higher in elderly than in young patients (p < 0.05). CONCLUSIONS: Elderly patients with DVT reveal higher prevalence and have different clinical features than young or adult patients. Further studies are needed to better evaluate predisposing conditions and clinical outcomes of DVT in old age.