In-Hospital Risks and Management of Deep Venous Thrombosis According to Location of the Thrombus |
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| Authors: | Paul D Stein Fadi Matta Mary J Hughes |
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| Institution: | 1. Center for Medical Training, Ehime Seikyo Hospital, Japan;2. Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Japan;1. Department of Philosophy, Texas Tech University, Lubbock;2. Texas Tech University Health Sciences Center, School of Medicine, Lubbock;1. Department of Psychiatry, Yale University School of Medicine, New Haven, Conn;2. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;1. Department of Internal Medicine, Yale School of Medicine, New Haven, Conn;2. Department of Pharmacy and Health Systems Science, Northeastern School of Pharmacy, Boston, Mass;3. Leon H. Charney Division of Cardiology, Department of Medicine;4. Division of Healthcare Delivery Science, Department of Population Health, New York University School of Medicine, New York, NY;5. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester;2. University of Arizona Department of Medicine, Tucson;4. Department of Medicine, New York Medical College/Westchester Medical Center Health Care System, Valhalla, NY |
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| Abstract: | BackgroundWhether deep venous thrombosis involving the pelvic veins or inferior vena cava is associated with higher in-hospital mortality or higher prevalence of in-hospital pulmonary embolism than proximal or distal lower extremity deep venous thrombosis is not known.MethodsThis was a retrospective cohort study based on administrative data from the Nationwide Inpatient Sample, 2016, 2017. Patients hospitalized with a primary diagnosis of deep venous thrombosis at known locations were identified by International Classification of Diseases-10-Clinical Modification codes.ResultsIn-hospital all-cause mortality with deep venous thrombosis involving the inferior vena cava in patients treated only with anticoagulants was 2.2% versus 0.8% with pelvic vein deep venous thrombosis (p<0.0001), 0.7% with proximal deep venous thrombosis (p<0.0001) and 0.2% with distal deep venous thrombosis (p<0.0001). Mortality with anticoagulants was similar with pelvic vein deep venous thrombosis compared with proximal lower extremity deep venous thrombosis, 0.8% versus 0.7% (p=0.39). Lower mortality was shown with pelvic vein deep venous thrombosis treated with thrombolytics than with anticoagulants, 0% versus 0.8% (p<0.0001). In-hospital pulmonary embolism occurred in 11% to 23%, irrespective of the site of deep venous thrombosis.ConclusionPatients with deep venous thrombosis involving the inferior vena cava had higher in-hospital mortality than patients with deep venous thrombosis at other locations. Pelvic vein deep venous thrombosis did not result in higher mortality or more in-hospital pulmonary embolism than proximal lower extremity deep venous thrombosis. The incidence of in-hospital pulmonary embolism was considerable with deep venous thrombosis at all sites. |
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| Keywords: | Deep venous thrombosis Pulmonary embolism Thrombolytic therapy Venous thromboembolism |
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