Premium
Risk Factors for Deep Vein Thrombosis in Older Patients: A Multicenter Study with Systematic Compression Ultrasonography in Postacute Care Facilities in France
Author(s) -
Sellier Elodie,
Labarere Jose,
Sevestre MarieAntoinette,
Belmin Joel,
Thiel Helene,
Couturier Pascal,
Bosson JeanLuc
Publication year - 2008
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01545.x
Subject(s) - medicine , odds ratio , deep vein , confidence interval , activities of daily living , thrombosis , cross sectional study , venous thrombosis , physical therapy , surgery , pathology
OBJECTIVES: To identify risk factors for deep vein thrombosis (DVT) in older patients with restricted mobility or functional disability. DESIGN: Cross‐sectional. SETTING: Forty‐two postacute care departments in France. PARTICIPANTS: Eight hundred twelve patients aged 65 and older. MEASUREMENTS: Twenty‐two predefined characteristics were investigated, including medical and surgical risk factors, dependence in six basic activities of daily living (ADLs) rated using the Katz index, mobility, the reported value of the Timed Up and Go Test, and pressure ulcers. All patients underwent lower limb ultrasonography on the day of the cross‐sectional study. RESULTS: DVT was found in 113 patients (14%, 33 proximal DVTs (4%) and 80 isolated distal DVTs (10%)). A positive trend was found in the odds of DVT for higher values on the Timed Up and Go Test for patients who were not bedridden or confined to a chair ( P =.007). In two‐level multivariable analysis adjusting for prophylaxis against venous thromboembolism, independent risk factors for DVT were aged 80 and older (adjusted odds ratio (aOR)=1.71, 95% confidence interval (CI)=1.05–2.79), previous history of venous thromboembolism (aOR=2.03, 95% CI=1.06–3.87), regional or metastatic‐stage cancer (aOR=2.71, 95% CI=1.27–5.78), dependence in more than three ADLs (aOR=2.18, 95% CI=1.38–3.45), and pressure ulcers (aOR=1.85, 95% CI=1.05–3.24). CONCLUSION: Severe dependence in basic ADLs and higher Timed Up and Go Test score are associated with greater odds of DVT in older patients in postacute care facilities in France.