Prevalence and Prevention of Deep Venous Thrombosis of the Lower Extremities in High-Risk Pulmonary Patients

Ibarra-Perez, Carlos; Lau-Cortes, Enrique; Colmenero-Zubiate, Sylvia; Arevila-Ceballos, Norma; Fong, J. Humberto; Sanchez-Martinez, Ricardo; Dominguez, Maria Victoria; Elizalde-Gonzalez, Jose
June 1988
Angiology;Jun1988, Vol. 39 Issue 6, p505
Academic Journal
Information is lacking about the prevalence of, and the best method of preventing deep venous thrombosis (DVT) of the lower extremities in patients forty years or older with pulmonary disease that keeps them in bed for three consecutive days or more and who are thus at high risk of developing DVT or pulmonary embolism (PE). In this study, 192 high-risk patients, aged forty to ninety-two, received 125I fibrinogen and had daily radioactive scans, venous Doppler, and strain gauge plethysmography. Four preventive methods were used until patients became ambulatory: graded compression stockings (GCS) in 39, elastic bandages (EB) in 33, subcutaneous administration of 5,000 USP units of heparin (HEP) bid in 39, and oral administration of 0.5 g of acetylsalicydic acid (ASA) bid in 35. Results were compared with those in 46 patients in a control group (CG). Twelve patients in CG, none in GCS, 4 in EB, 1 in HEP, and 2 in ASA developed DVT proved by contrast venography. There was a statistically significant difference between GCS and CG (P < 0.0003), HEP and CG (P < 0.0022), and ASA and CG (P < 0.0148) but not between EB and CG (P > 0.10); no significant differences were found between any pair of prophylaxis groups. The significant differences could not be attributed to differences in age, sex, or length of stay in bed. PE occurred in 3 patients in CG and 1 in EB. Hemorrhagic complications occurred in 7 patients in HEP and 4 in ASA, requiring exclusion of 2 patients and 1 patient, respectively, from the study. GCS, HEP, and ASA are effective methods of preventing DVT in high-risk pulmonary patients, in whom the disease is highly prevalent (26%). Effectiveness, invasiveness, simplicity of use, side effects, and price should be considered in choosing among them.


Related Articles

  • Potential of an age adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism in older patients: a retrospective analysis of three large cohorts.  // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;4/30/2010, Vol. 340 Issue 7753, p962 

    The article discusses the study on the potential of the age adjusted D-dimer cut-off value to improve exclusion of pulmonary embolism in older patients. It mentions that the cut-off value combined with clinical probability assessment can greatly increase the proportion of older patients with...

  • CITATIONS AND CLINICIANS' NOTES: PULMONARY EMBOLISM.  // Current Medical Literature: Respiratory Medicine;2004, Vol. 18 Issue 3, p75 

    The article presents an understanding on pulmonary embolism. Low-molecular-weight heparins (LMWH) has largely superseded unfractionated heparin for the treatment of venous thromboembolic disease. LMWH was superior to unfractionated heparin in patients with isolated deep vein thrombosis (DVT) and...

  • Guidelines for DVT/PE prevention scarce, survey finds.  // Formulary;Sep97, Vol. 32 Issue 9, p902 

    Presents the survey on the formal guidelines or standing order on the use of drugs for deep vein thrombosis (DVT) and pulmonary embolism (PE) prevention. Percentage of institutions having guidelines for DVT/PE prophylaxis.

  • Pulmonary embolism. Falotico, Jane Bondi // RN;Feb79, Vol. 42 Issue 2, p47 

    Presents information about pulmonary embolism. People at risk for pulmonary embolism; Symptoms; Treatment.

  • Part II--Natural History.  // British Medical Journal;5/15/1976, Vol. 1 Issue 6019, p1181 

    Focuses on the natural history of venous thromboembolic disease. Development of thrombosis at the independent sites in the venous system of the leg; Absence of the incidence of definite and probable pulmonary embolism after strokes; Occurrence of thrombosis from the calf.

  • Fibrinogen.  // Reactions Weekly;12/15/2012, Issue 1432, p25 

    The article describes the case of a female patient who developed pulmonary embolism during off-label use of fibrinogen concentrate (Riastap) to treat acquired hypofibrinogenaemia.

  • CITATIONS AND CLINICIANS' NOTES: PULMONARY VASCULATURE.  // Current Medical Literature: Respiratory Medicine;2004, Vol. 18 Issue 1, p23 

    Presents citations and clinicians' notes on studies on pulmonary vasculature. "Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism," by H.R. Buller, et al; "Does interferon-gamma improve pulmonary function in idiopathic pulmonary...

  • Thromboembolism Prophylaxis Underused in Patients With Severe Lung Disease. Theuvenin, Frederique H. // Pulmonary Reviews;Feb2011, Vol. 16 Issue 2, p1 

    The article reports that patients with severe lung disease are not maximizing therapies for preventing thromboembolism. Findings based on guidelines of the American College of Chest Physicians suggest that patients with respiratory illness are at high risk for deep-venous thrombosis (DVT) and...

  • Heparin prophylaxis for deep venous thrombosis in a patient with multiple injuries: an evidence-based approach to a clinical problem. Hill, Andrew B.; Garber, Brian; Dervin, Geoffrey; Howard, Andrew // Canadian Journal of Surgery;Aug2002, Vol. 45 Issue 4, p282 

    Examines the efficacy of heparin prophylaxis for deep venous thrombosis in a patient with multiple injuries. Decrease of pulmonary embolism; Reduction of phlebitis and trauma; Elimination of external injuries.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics