Lower extremity deep vein thrombosis among intensive care patients in Orotta national referral hospital, Asmara, Eritrea

Abstract

Background: Deep Venous Thrombosis (DVT) with Venous Thromboembolism (VTE) is a major health problem with high mortality throughout the world. The patients at risk must be identified and given appropriate prophylaxis in order to decrease the mortality. Objective: To investigate and identify risk factors associated with DVT. Design: A retrospective medical chart review. Setting: Orotta National Referral Hospital, the largest teaching hospital in Eritrea. Methods: Review of medical records of all patients with final diagnosis of DVT between January 2005 and December 2008. Results: Of the 1,110 ICU admissions, 91 (8%) had lower extremity DVT. The mean age of these patients was 50 years and male to female ratio was 0.9 to 1. One or more risk factors for DVT from the following list; associated medical conditions contributed to 23 cases (25%), followed by post delivery(19%), major surgery (15%), malignancy (11%),
pregnancy (6%), post trauma (6%), varicose vein (3%) and previous DVT (2%) were identified in 98% of the cases in the study population. Two or more risk factors were documented in 41% of the cases. The maximum number of DVT cases was recorded in the age-group of 30 to 39 years. In the absence of other known risk factors, age of 50 and above was observed as a risk factor in (11%) of the cases. No risk factor was identified in 2% of the cases. None of these patients had received any form of prophylaxis. Conclusion: Like elsewhere in the world, in Eritrea, DVT is a major health problem. Medical, surgical conditions and puerperium are among the most important risk factors identified. Prophylaxis against VTE was highly under utilised by the physicians and was not provided to any of the patients in the study. This study emphasizes the urgent need to implement DVT risk stratification strategy and to provide prophylaxis unless contraindicated.