Cargando…

Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases

PURPOSE: Comatose elderly patients with acute neurological illness have a great risk of deep vein thrombosis (DVT). In this study, the incidence of DVT and the effectiveness of early initiation of treatment were evaluated in those patients. MATERIALS AND METHODS: Total 323 patients were admitted to...

Descripción completa

Detalles Bibliográficos
Autores principales: Yamada, Shoko Merrit, Tomita, Yusuke, Murakami, Hideki, Nakane, Makoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740531/
https://www.ncbi.nlm.nih.gov/pubmed/26847291
http://dx.doi.org/10.3349/ymj.2016.57.2.388
_version_ 1782413866001498112
author Yamada, Shoko Merrit
Tomita, Yusuke
Murakami, Hideki
Nakane, Makoto
author_facet Yamada, Shoko Merrit
Tomita, Yusuke
Murakami, Hideki
Nakane, Makoto
author_sort Yamada, Shoko Merrit
collection PubMed
description PURPOSE: Comatose elderly patients with acute neurological illness have a great risk of deep vein thrombosis (DVT). In this study, the incidence of DVT and the effectiveness of early initiation of treatment were evaluated in those patients. MATERIALS AND METHODS: Total 323 patients were admitted to our ward due to neurological diseases in one year, and 43 patients, whose Glasgow Coma Scale was ≤11 and who was older than ≥60 years, were included in this study. D-dimer was measured on admission and day 7, and lower-extremity ultrasonography was performed on day 7. When DVT was positive, heparin treatment was initiated, and further evaluation of pulmonary embolism (PE) was conducted. Vena cava filter protection was inserted in PE-positive patients. Incidence of DVT and PE, alteration of D-dimer value, and effect of heparin treatment were analyzed. RESULTS: DVT was positive in 19 (44.2%) patients, and PE was in 4 (9.3%). D-dimer was significantly higher in DVT-positive group on day 7 (p<0.01). No DVT were identified in patients with ischemic disease, while 66.7% of intracerebral hemorrhage and 53.3% of brain contusion patients were DVT positive. Surgery was a definite risk factor for DVT, with an odds ratio of 5.25. DVT and PE disappeared by treatment in all cases, and no patients were succumbed to the thrombosis. CONCLUSION: Patients with hemorrhagic diseases or who undergo operation possess high risk of DVT, and initiation of heparin treatment in 7 days after admission is an effective prophylaxis for DVT in comatose elderly patients without causing bleeding.
format Online
Article
Text
id pubmed-4740531
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Yonsei University College of Medicine
record_format MEDLINE/PubMed
spelling pubmed-47405312016-03-01 Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases Yamada, Shoko Merrit Tomita, Yusuke Murakami, Hideki Nakane, Makoto Yonsei Med J Original Article PURPOSE: Comatose elderly patients with acute neurological illness have a great risk of deep vein thrombosis (DVT). In this study, the incidence of DVT and the effectiveness of early initiation of treatment were evaluated in those patients. MATERIALS AND METHODS: Total 323 patients were admitted to our ward due to neurological diseases in one year, and 43 patients, whose Glasgow Coma Scale was ≤11 and who was older than ≥60 years, were included in this study. D-dimer was measured on admission and day 7, and lower-extremity ultrasonography was performed on day 7. When DVT was positive, heparin treatment was initiated, and further evaluation of pulmonary embolism (PE) was conducted. Vena cava filter protection was inserted in PE-positive patients. Incidence of DVT and PE, alteration of D-dimer value, and effect of heparin treatment were analyzed. RESULTS: DVT was positive in 19 (44.2%) patients, and PE was in 4 (9.3%). D-dimer was significantly higher in DVT-positive group on day 7 (p<0.01). No DVT were identified in patients with ischemic disease, while 66.7% of intracerebral hemorrhage and 53.3% of brain contusion patients were DVT positive. Surgery was a definite risk factor for DVT, with an odds ratio of 5.25. DVT and PE disappeared by treatment in all cases, and no patients were succumbed to the thrombosis. CONCLUSION: Patients with hemorrhagic diseases or who undergo operation possess high risk of DVT, and initiation of heparin treatment in 7 days after admission is an effective prophylaxis for DVT in comatose elderly patients without causing bleeding. Yonsei University College of Medicine 2016-03-01 2016-01-28 /pmc/articles/PMC4740531/ /pubmed/26847291 http://dx.doi.org/10.3349/ymj.2016.57.2.388 Text en © Copyright: Yonsei University College of Medicine 2016 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Yamada, Shoko Merrit
Tomita, Yusuke
Murakami, Hideki
Nakane, Makoto
Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases
title Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases
title_full Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases
title_fullStr Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases
title_full_unstemmed Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases
title_short Deep Vein Thrombosis in the Lower Extremities in Comatose Elderly Patients with Acute Neurological Diseases
title_sort deep vein thrombosis in the lower extremities in comatose elderly patients with acute neurological diseases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740531/
https://www.ncbi.nlm.nih.gov/pubmed/26847291
http://dx.doi.org/10.3349/ymj.2016.57.2.388
work_keys_str_mv AT yamadashokomerrit deepveinthrombosisinthelowerextremitiesincomatoseelderlypatientswithacuteneurologicaldiseases
AT tomitayusuke deepveinthrombosisinthelowerextremitiesincomatoseelderlypatientswithacuteneurologicaldiseases
AT murakamihideki deepveinthrombosisinthelowerextremitiesincomatoseelderlypatientswithacuteneurologicaldiseases
AT nakanemakoto deepveinthrombosisinthelowerextremitiesincomatoseelderlypatientswithacuteneurologicaldiseases