Deep venous thrombosis of lower limbs in adolescents: a study in a tertiary hospital

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Catarina Faria ◽  
Henedina Antunes ◽  
Teresa Pontes ◽  
Ana Antunes ◽  
Sofia Martins ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Oral Contraceptive ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Positive Family History ◽  
Oral Contraceptive Pill ◽  
Tertiary Hospital ◽  
Lower Limbs ◽  
Factor V Leiden Mutation

AbstractBackgroundVenous thromboembolism (VTE) – which includes deep venous thrombosis (DVT) and pulmonary embolism (PE) – has been increasingly recognized in the pediatric population. The estimated incidence is 0.07–0.14 cases per 10,000 children. Most cases are associated with two or more risk factors. Medium and long-term complications include recurrence and post-thrombotic syndrome (PTS).ObjectiveTo characterize the adolescent population with the diagnosis of DVT of lower limbs in a tertiary hospital, regarding its clinical presentation, associated risk factors, treatment and outcome.MethodsRetrospective analysis of adolescents with the diagnosis of DVT of lower limbs in our hospital for a period of 7 years.ResultsEight patients were identified; seven were females; median age was 15 years. The main symptoms were local pain and edema. Left lower limb was affected in six patients. PE occurred in two cases. Positive family history of venous thromboembolism was found in five patients. Seven patients had at least two identifiable risk factors. Combined oral contraceptive pill use was the most common (seven patients). Factor V Leiden mutation was found in three patients and protein C deficiency in one. Iliac vein compression syndrome was diagnosed in one patient. The median time for discharge was 8 days. Election treatment was enoxaparin followed by warfarin, for a median period of 10.9 months. Three patients developed PTS.ConclusionsAlthough uncommon, VTE is an emerging reality in adolescents, particularly in females using oral contraceptive pills. Appropriated prevention strategies and treatment are required as most orientations are extrapolated from adults.

scholarly journals Analysis of Risk Factors of Stroke and Venous Thromboembolism in Females With Oral Contraceptives Use

2017 ◽  
Vol 24 (5) ◽  
pp. 797-802 ◽  
Author(s):  
Petr Dulicek ◽  
Eva Ivanova ◽  
Milan Kostal ◽  
Petr Sadilek ◽  
Martin Beranek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Oral Contraceptive ◽  
Cigarette Smoking ◽  
Venous Thrombosis ◽  
Arterial Thrombosis ◽  
Contraceptive Use ◽  
Additional Risk ◽  
Inherited Thrombophilia ◽  
Oral Contraceptive Use

Thrombotic diathesis has been a well-known complication of oral contraceptive use for more than 50 years. This is true not only for venous thrombosis but also for an arterial one. The etiology is usually multifactorial and depends on several additional risk factors. We analyzed the prevalence of inherited and acquired thrombophilia in a cohort of 770 females who had a thrombotic event in association with oral contraceptive use (700 women with venous thromboembolism [VTE], 70 with stroke). Moreover, we tried to identify additional risk factors. Inherited thrombophilia was found in 44.5% with higher frequency in the cohort with VTE (42%) than in females with stroke (24%). The most frequent finding was factor V Leiden. Cigarette smoking was significantly more frequent in the group with stroke (50% vs 25%). The prevalence of cigarette smoking in the group with VTE did not exceed the frequency in general population. Women on oral contraceptive pills have higher risk of venous as well as arterial thrombosis. The risk of venous thrombosis is increased in females with inherited thrombophilia, whereas those with some additional acquired risk factors (especially smoking) may be predisposed to arterial thrombosis. However, the absolute risk of thrombosis in healthy women is low, far less than the risk of unintended pregnancy. Moreover, the risk may be reduced by keeping some rules before the prescription of the pills, healthy life style, and a proper choice of contraception.

scholarly journals Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis

2021 ◽  
Vol 10 (22) ◽  
pp. 5412
Author(s):  
Karsten Keller ◽  
Jens Wöllner ◽  
Volker H. Schmitt ◽  
Mir A. Ostad ◽  
Ingo Sagoschen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Hospital Mortality ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Strong Predictor ◽  
Acute Paraplegia ◽  
The Impact

Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis or thrombophlebitis (DVT). Methods: Patients were selected by screening the German nationwide inpatient sample (2005–2017) for paralysis, and were stratified for venous thromboembolism (VTE) and the VTE-sub-entity PE (ICD-code I26). Impact of PE on mortality and predictors for PE were analyzed. Results: Overall, 7,873,769 hospitalizations of patients with paralysis were recorded in Germany 2005–2017, of whom 1.6% had VTE and 7.0% died. While annual hospitalizations increased (2005: 520,357 to 2017: 663,998) (β 12,421 (95% CI 10,807 to 14,034), p < 0.001), in-hospital mortality decreased from 7.5% to 6.7% (β −0.08% (95% CI −0.10% to −0.06%), p < 0.001). When focusing on 82,558 patients with paralysis hospitalized due to VTE (51.8% females; 58.3% aged ≥ 70 years) in 2005–2017, in-hospital mortality was significantly higher in patients with paralysis and PE than in those with DVT only (23.8% vs. 6.3%, p < 0.001). Cancer (OR 2.18 (95% CI 2.09–2.27), p < 0.001), heart failure (OR 1.83 (95% CI 1.76–1.91), p < 0.001), COPD (OR 1.63 (95% CI 1.53–1.72), p < 0.001) and obesity (OR 1.42 (95% CI 1.35–1.50), p < 0.001) were associated with PE. PE (OR 4.28 (95% CI 4.07–4.50), p < 0.001) was a strong predictor of in-hospital mortality. Conclusions: In Germany, annual hospitalizations of patients with paralysis increased in 2005–2017, in whom VTE and especially PE substantially affected in-hospital mortality. Cancer, heart failure, COPD, obesity and acute paraplegia were risk factors of PE.

Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis of the lower limb

2013 ◽  
Vol 29 (7) ◽  
pp. 442-446 ◽  
Author(s):  
Fenghe Li ◽  
Xuehu Wang ◽  
Wen Huang ◽  
Wei Ren ◽  
Jun Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Odds Ratio ◽  
Heart Diseases ◽  
Lower Limbs ◽  
Chi Square ◽  
Chi Square Test ◽  
The Right

Objective The aim of our study is to investigate the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in the lower limbs and to evaluate the associated risk factors. Methods A total of 322 patients with acute deep venous thrombosis confirmed by CT venography or Doppler ultrasonography were studied. The diagnosis of silent pulmonary embolism was established by computed tomography pulmonary arteriography (CTPA). The association between covariates and the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs were assessed using chi-square test and multivariable regression. Results The incidence of silent pulmonary embolism was 33.5% (108 in 322 patients) in all patients with deep venous thrombosis in lower limbs. Chi-square test showed male gender, the right lower limb, proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases were related to a higher incidence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs. The multivariate regression analysis confirmed that the risk factors associated with silent pulmonary embolism in deep venous thrombosis patients included the right side and proximal location of the thrombus (odds ratio: 2.023, 95% CI: 1.215–3.368; odds ratio: 3.610, 95% CI: 1.772–7.354), unprovoked venous thrombosis (odds ratio: 2.037, 95% CI: 1.188–3.493), coexisting heart diseases (odds ratio: 4.507, 95% CI: 2.667–7.618). Conclusion Silent pulmonary embolism occurred frequently in patients with deep venous thrombosis in lower limbs. The right side, the proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases increased the risk for the occurrence of silent pulmonary embolism.

scholarly journals Massive Fatal Pulmonary Embolism While on Therapeutic Heparin Drip

2020 ◽  
Vol 8 ◽  
pp. 232470962091478
Author(s):  
Said Hajouli
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Fatal Pulmonary Embolism ◽  
Heparin Infusion ◽  
Therapeutic Anticoagulation

Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE). In this article, we present a case of a patient with an acute DVT who was treated with a therapeutic heparin drip, then developed syncope while in the hospital and found to have massive bilateral PEs. This case aims to arouse the medical staff’s awareness of the VTE diagnosis even if the patient is fully anticoagulated. We review the indications for DVT hospitalization, heparin infusion monitoring, risk factors for developing PE from DVT, mechanisms of developing PE from DVT while on therapeutic anticoagulation, and signs and treatment of massive PE.

scholarly journals Risk factors for deep venous thrombosis of lower limbs in postoperative neurosurgical patients

2016 ◽  
Vol 32 (5) ◽  
Author(s):  
Qiang Li ◽  
Zongxue Yu ◽  
Xiao Chen ◽  
Jinjun Wang ◽  
Guixi Jiang
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Lower Limbs ◽  
Neurosurgical Patients

scholarly journals Minor Events and the Risk of Deep Venous Thrombosis

2000 ◽  
Vol 83 (03) ◽  
pp. 408-411 ◽  
Author(s):  
E. M. W. Eekhoff ◽  
J. P. Vandenbroucke ◽  
F. R. Rosendaal
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Odds Ratio ◽  
Factor V Leiden ◽  
Common Disease ◽  
Factor V ◽  
Factor V Leiden Mutation ◽  
Synergy Index

SummaryBackground Deep venous thrombosis is a common disease, with genetic and acquired risk factors. Many patients have a history of minor events (short periods of immobilisation such as prolonged travel, short illness, minor surgery or injuries) before onset of venous thrombosis. However, the role of these minor events has received little formal study. Also, we do not know how minor events might interact with the presence of genetic prothrombotic defects (factor V Leiden mutation, factor II mutation, protein C, S and antithrombin deficiency). Patients and Methods On the basis of case-control data from a thrombosis service in the Netherlands, we added a follow-up period for a casecross-over analysis of minor events as risk factors, and a case-only analysis for the interaction with factor V Leiden. A total of 187 patients with first, objectively diagnosed venous thrombosis of the legs, aged 15–70, without underlying malignancies and without major acquired risk factors entered the study. For the analysis of minor events in the case-cross-over analysis, we used a matched odds ratio; in the caseonly analysis, we used the multiplicative synergy index. Results In 32.6% of the 187 patients with deep venous thrombosis who did not have major acquired risk factors, minor events were the only external risk factors. Minor events increased the risk of thrombosis about 3-fold, as estimated in the case-cross-over analysis (odds ratio 2.9, 95% confidence interval 1.5–5.4). The synergy index between minor events and factor V Leiden mutation in the case-only analysis was 0.7 (95% confidence interval 0.3–1.5). Therefore, persons with factor V Leiden mutation who experience a minor event will have an estimated risk increase of about 17-fold, which exceeds the sum of the individual risk factors. Conclusions Minor events are likely to play an important role in the development of deep venous thrombosis, especially in the presence of genetic prothrombotic conditions.

scholarly journals Thromboembolic complications during pregnancy and delivery

2013 ◽  
Vol 66 (9-10) ◽  
pp. 417-423 ◽  
Author(s):  
Radmila Sparic ◽  
Biljana Lazovic ◽  
Zoran Stajic ◽  
Sanja Mazic ◽  
Marina Djelic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Central Place ◽  
Pulmonary Angiography ◽  
Pregnancy And Delivery ◽  
Pass Through ◽  
In Pregnancy

Introduction. Venous thromboembolism is one of the leading cause of maternal mortality worldwide. The incidence of venous thromboembolism is estimated at 0.76 to 1.72 per 100.000 pregnancies which is four times as great as the risk in nonpregnant women. The purpose of this article is to raise awareness of this frequent problem in pregnancy and provide a practical approach for the diagnosis, management, and prevention of venous thromboembolism during pregnancy and delivery. Risk factors. A number of risk factors for the development venous thromboembolism have been identified. The two most important risk factors for venous thromboembolism in pregnancy are thrombophilia and previous venous thromboembolism. Deep venous thrombosis in the majority of cases occurs in the lower extremities and pelvis. Diagnosis. As the clinical diagnosis of venous thromboembolism is unreliable, the women who are suspected of having deep venous thrombosis or pulmonary embolism should be examined promptly using imaging diagnostics. The first diagnostic method is Doppler ultrasound. Where available, individual authors recommend magnetic resonance venography, pulmonary angiography or computed tomography. Therapy. Unfractionated heparin or low-molecularweight heparin has a central place in the prevention and treatment of venous thromboembolism in pregnancy because they do not pass through the placenta, thus avoiding the risks likely to be induced by warfarin. The prevention of venous thromboembolism must focus on the patients known to be at high risk bearing in mind that the recommendations for prophylaxis, even in high-risk patients, are based on the limited data.

scholarly journals Deep Venous Thrombosis of Lower Limbs: Prevalence, Risk Factors and Treatment in Semi-Urban Areas in Senegal

2021 ◽  
Vol 11 (04) ◽  
pp. 194-200
Author(s):  
S. J. Manga ◽  
A. Ben Haj Younes ◽  
M. Dioum ◽  
S. L. Sy ◽  
Q. Te Indafa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Urban Areas ◽  
Lower Limbs

Risk factors for cancer-associated venous thromboembolism in outpatient deep venous thrombosis clinics

2010 ◽  
Vol 150 (5) ◽  
pp. 640-641 ◽  
Author(s):  
Peter Rose ◽  
Aidan McManus ◽  
Roopen Arya ◽  
Nicholas Scriven ◽  
Timothy Farren ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis
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