Majority of DVT Cases After Surgery Linked to Catheter Use

Overall incidence of DVT after general surgery low; higher in patients with upper extremity catheter

THURSDAY, Aug. 18 (HealthDay News) -- Following general surgical operations, the incidence of deep venous thrombosis (DVT) is low, but more than 60 percent of cases are catheter-induced, according to a study published online Aug. 15 in the Archives of Surgery.

Brian R. Smith, M.D., from the University of California in Orange, and colleagues characterized the location, incidence, and timing of DVT after surgery by reviewing data from 2,189 patients who underwent general surgical operations, including pancreatic, esophagogastric, intestinal/colorectal, and other surgery. Patient characteristics, location of DVT, time of DVT diagnosis from the index operation, time of diagnosis according to discharge, associated pulmonary embolism, and mortality were the main outcome measures.

The investigators found that 35 patients (1.6 percent) developed DVT, which was diagnosed on the basis of symptoms and routine duplex screening in 94.3 and 5.7 percent of patients, respectively. DVT occurred in the upper, lower, and combined upper and lower extremity in 40, 45.7, and 14.3 percent of patients, respectively. DVT diagnoses were made in an inpatient setting in 83 percent of patients, and the mean time of diagnosis from index operation was 8.6 days. Twenty one patients with DVT (60 percent) had an indwelling central or peripherally inserted central catheter, with 19 patients having an upper extremity catheter and two having a femoral catheter. Other concomitant complications, including ventilator dependency, sepsis, renal failure, surgical site infection, and pneumonia, were observed in 62.9 percent of patients. The 30-day mortality was 14.2 percent.

"The incidence of DVT after general surgical operations is low, with most cases diagnosed as inpatients. With more than half of DVTs being caused by central catheters, efforts toward DVT prevention should include closer scrutiny to the need for central catheters," the authors write.

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