The prevalence of deep venous thrombosis in Chinese medical ICU patients

Introduction and aim

The incidence of deep venous thrombosis (DVT) in critically ill medical patients is approximately 30% [1, 2]. The proportion of proximal lower limb thrombi (above the knee) is reported to be approximately 50% [1]. However, several studies in Chinese patients have shown a markedly lower rate of DVT than reported in Caucasian populations [3]. The aim of this study was to determine the frequency of DVT in Chinese medical ICU patients not receiving prophylaxis.

Methods

We studied a prospective cohort of adult Chinese medical patients admitted to the ICU and expected to stay longer than 48 hours. Existing policy was to not routinely prescribe DVT prophylaxis in Chinese patients. Patients with previously diagnosed DVT, or already receiving anticoagulant therapy, were excluded. Screening for lower limb DVT was performed twice weekly in the ICU and repeated 1 week after discharge. DVT was detected by compression and duplex Doppler ultrasound.

Results

Seventy-eight patients were entered. One patient died within 48 hours and was excluded. Fourteen patients (18%) died in the ICU after 48 hours and at least one ultrasound examination. Of the 77 patients evaluated, 14 (18%) demonstrated DVT. On five of 14 occasions (36%), thrombus was present in both limbs. Proximal (above knee) DVT was present in three of 14 patients (20%).

Discussion and conclusion

The prevalence of DVT in Chinese medical ICU patients is lower, by approximately 50%, than that reported for Caucasian medical ICU patients. The proportion of proximal lower limb thrombi is also lower. We believe the prevalence is sufficient, however, to justify the use of DVT prophylaxis. The data support the need further studies to quantify the possible benefit of DVT prophylaxis in this group.