Risk Factors and Prophylactic Anticoagulation Therapy of Deep Vein Thrombosis in Lower Extremity

ABSTRACT

PURPOSE: Deep vein thrombosis of the lower extremity is a frequent disorder which may either occur spontaneously or following a high-risk situation such as major surgical procedures or prolonged period of immobilization. Untreated deep vein thrombosis is associated with morbidity and mortality due to pulmonary embolism and the postthrombotic syndrome. Factors in predicting the risk of deep vein thrombosis can be influenced by the variations of the medical and surgical conditions associated with it. Within the last few years, the knowledge of hereditary and acquired risk factor for deep vein thrombosis have increased, but yet not justified. METHOD: We describe why certain individuals develop deep vein thrombosis at varying times despite of similar risk factors, and also assess risk stratification as well as the value of thromboprophylaxis in medical and surgical patients. From January 1990 to December 1998, 73 patients who have developed deep vein thrombosis were admitted to our hospital. The patients' charts were reviewed retrospectively about risk factors according to age, site, associated medical and surgical conditions. RESULT: The older patients who have developed deep vein thrombosis generally had systemic disease, however the younger patient who have developed deep vein thrombosis had trauma, operation, previous deep vein thrombosis. The duplex scan was sufficient and accurate modality for diagnosis of deep vein thrombosis. CONCLUSION: The patients with risk factor may need to be under close observation and when deep vein thrombosis is diagnosed, prophylactic anticoagulation therapy may be beneficiary for patient's prognosis and pulmonary embolism prevalence. Further clinical research may be needed to help develop accurate methods of risk stratification and to clarify the benefits of thromboprophylaxis in high risk group.