The risk factors for deep venous thrombosis in critically ill older adult patients: a subgroup analysis of a prospective, multicenter, observational study

BMC Geriatrics

Research

Weimin Zhang¹  Lina Yao²  Qijiang Chen³  Bihuan Cheng⁴  Gensheng Zhang⁵  Lingen Xu⁶  Guolong Cai⁷  Li Li⁷  Junhai Zhen⁷  Shijin Gong⁷  Jia Zhou⁷  Jing Yan⁷  Liquan Huang⁸  Ronglin Jiang⁸ 

[1] Department of Critical Care Medicine, Dongyang People’s Hospital, 60 Wuning West Road, Dongyang, 322100, Jinhua City, China;Department of Critical Care Medicine, Ningbo Yinzhou People’s Hospital, 58 Zhoumeng North Road, Yinzhou, 315100, Ningbo City, China;Department of Critical Care Medicine, Ninghai First Hospital, 142 Taoyuan Middle Road, Ninghai, 315600, Ningbo City, China;Department of Critical Care Medicine, The 2nd School of Medicine, Wenzhou Medical University, 109 West Xueyuan Road, 325027, Wenzhou, China;Department of Critical Care Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, 88 Jiefang Road, 310009, Hangzhou, China;Department of Critical Care Medicine, Xinchang Hospital of Traditional Chinese Medicine, 188 Jiufeng Road, Xinchang, 312500, Shaoxing City, China;Department of Critical Care Medicine, Zhejiang Hospital, 12 Lingyin Road, 310013, Hangzhou, China;Department of Critical Care Medicine, Zhejiang Provincial Hospital of Chinese Medicine, 54 Youdian Road, 310013, Hangzhou, China;

关键词: Older adult patients;    Intensive care unit;    Deep venous thrombosis;    Venous thromboembolism;    Risk factor;    China;   

DOI  :  10.1186/s12877-022-03599-y

 received in 2022-03-09, accepted in 2022-11-08,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundOlder adult patients mainly suffer from multiple comorbidities and are at a higher risk of deep venous thrombosis (DVT) during their stay in the intensive care unit (ICU) than younger adult patients. This study aimed to analyze the risk factors for DVT in critically ill older adult patients.MethodsThis was a subgroup analysis of a prospective, multicenter, observational study of patients who were admitted to the ICU of 54 hospitals in Zhejiang Province from September 2019 to January 2020 (ChiCTR1900024956). Patients aged > 60 years old on ICU admission were included. The primary outcome was DVT during the ICU stay. The secondary outcomes were the 28- and 60-day survival rates, duration of stay in ICU, length of hospitalization, pulmonary embolism, incidence of bleeding events, and 60-day coagulopathy.ResultsA total of 650 patients were finally included. DVT occurred in 44 (2.3%) patients. The multivariable logistic regression analysis showed that age (≥75 vs 60-74 years old, odds ratio (OR) = 2.091, 95% confidence interval (CI): 1.308-2.846, P = 0.001), the use of analgesic/sedative/muscarinic drugs (OR = 2.451, 95%CI: 1.814-7.385, P = 0.011), D-dimer level (OR = 1.937, 95%CI: 1.511-3.063, P = 0.006), high Caprini risk score (OR = 2.862, 95%CI: 1.321-2.318, P = 0.039), basic prophylaxis (OR = 0.111, 95%CI: 0.029-0.430, P = 0.001), and physical prophylaxis (OR = 0.322, 95%CI: 0.109-0.954, P = 0.041) were independently associated with DVT. There were no significant differences in 28- and 60-day survival rates, duration of stay in ICU, total length of hospitalization, 60-day pulmonary embolism, and coagulation dysfunction between the two groups, while the DVT group had a higher incidence of bleeding events (2.6% vs. 8.9%, P < 0.001).ConclusionIn critically ill older adult patients, basic prophylaxis and physical prophylaxis were found as independent protective factors for DVT. Age (≥75 years old), the use of analgesic/sedative/muscarinic drugs, D-dimer level, and high Caprini risk score were noted as independent risk factors for DVT.Trial registrationChinese Clinical Trial Registry (ChiCTR1900024956).URL: http://www.chictr.org.cn/listbycreater.aspx.

【 授权许可】

CC BY   
© The Author(s) 2022

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