May, 2007

Author: Dr LIONG TING (Intensive Care Unit, United Christian Hospital)

ABSTRACT

Introduction
Patients in intensive care unit (ICU) are predisposed to the development of deep vein thrombosis (DVT) because they have many risk factors that general population do not have, e.g. prolonged immobilization, sepsis, vascular injury due to indwelling central venous access etc. 
Studies reported that the incidence of venous thromboembolism (VTE) in ICU in Caucasians ranged from 5.4 to 33%. Therefore, it is recommended that all patients should be assessed for their risk of VTE on admission to ICU and most patients should receive DVT prophylaxis.
It is believed that Chinese population has lower risk and hence lower incidence of DVT.  Therefore, DVT prophylaxis is not routinely given to all critically ill patients in our local practice.  Whether this assumption is valid to both general population and critically ill patients or not is uncertain.

The aim of study
The aim of this study is to determine the incidence of lower extremities DVT in ethnic Chinese ICU patients in Hong Kong.

Methodology
This is a prospective observational cohort study carried out between mid August and mid December 2006.  All ICU patients recruited into the study would undergo bilateral lower extremities ultrasound Doppler screening regularly.  Besides, the demographic data, risk factors for DVT and potential complications were recorded.

Results
One hundred and sixty-two cases were recruited into the study.  Five patients were detected to have DVT during their stay in ICU.  The calculated incidence of DVT was 3.1% (95% confidence interval 0.5 – 5.7)

Conclusion
The incidence of DVT in ethnic Chinese critically ill patients is lower when compared to Caucasians.  This supports our usual practice that DVT prophylaxis is not routinely given to all patients in ICU.

 

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