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- Title
Lower-limb deep-vein thrombosis in a general hospital: risk factors, outcomes and the contribution of intravenous drug use.
- Authors
F.F. Syed; N.J. Beeching
- Abstract
Background: Much of the morbidity associated with deep-vein thrombosis (DVT) is absent from the evidence base used to define best clinical practice. Intravenous (IV) drug use is an increasingly frequent cause of DVT.Aim: To obtain a profile of DVT patients in routine clinical care, and determine the contribution of IV drug use.Design: Retrospective case-note review.Methods: We reviewed 232 episodes of lower-limb DVT in a large district general hospital during 1996.Results: Patients had mean (range) age 62.8 (2197) years, with 43.9% aged > 70 years. A large proportion would have been excluded from prospective studies that have contributed to current DVT guidelines. Risk factors included smoking (33.0%), immobility (26.5%), previous DVT (23.6%), surgery in the last 3 months (18.2%), malignancy (16.5%), varicose veins (10.5%) and IV drug use (6.9%). Forty-five (19.4%) had multiple risk factors. Postsurgical DVT commonly presented from the community following initial hospital discharge. Intravenous drug use accounted for 48.4% of episodes in patients aged =40 years. Thrombosis was right-sided in 68.8% of IV drug users, compared to 38.2% in others (p = 0.034).Discussion: Our patients differed from those in most of the prospective studies used to develop routine clinical care pathways for DVT. Intravenous drug use is an important cause of community-acquired DVT in young adults.
- Subjects
PREOPERATIVE risk factors; VARICOSE veins; BLOOD coagulation; CARDIOVASCULAR diseases
- Publication
QJM: An International Journal of Medicine, 2005, Vol 98, Issue 2, p139
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hci020