The Incidence Of Venous Thromboembolism(VTE) In The First Affiliated Hospital Of Kunming Medical University From 2017 To 2018

Objective:The aim of our study was to determine the incidence of VTE in hospitalized patients of The First Affiliated Hospital of Kunming Medical University.The seeondary purpose was to correlate the observed incidence rate with the risk factors and common comorbid conditions of the patients.Methods:In this prospective observational study,data were obtained from the hospitalized patients of The First Affiliated Hospital of Kunming Medical University between January 2017 and December 2018.We included all the hospitalized patients with primary or secondary diagnosis of VTE.Our primary outcome was incidence of VTE in the hospitalized patients of The First Affiliated Hospital of Kunming Medical University.The secondary outcomes were average length of stay,lab reference values(D-dimer and RDW),risk factors and comorbidities,sites of thrombi and in-hospitalization mortality of the hospitalized pat'ients with the diagnosis of VTE.Results:A total of 822 patients who were above 18 years were diagnosed with VTE during our study period.Of these,576 patients were enrolled:PE with or without DVT 55.73%and DVT only 44.27%.1.The incidence and mortality rates of VTE in the hospitalized patients were 185 per 100,000 population per annum and 1.04%,respectively.2.The mean length of hospital stay(LOS)was 12.55±5.982 days in PE with or without DVT and 9.21 ±4.808 days for DVT only patients(p=0.00).3.The lab reference values of D-dimer in PE with or without DVT and DVT only patients were 11.189±8.51 ?g/mL and 9.950±11.556 ?g/mL(p=0.898),respectively.Similarly,the lab reference values of RDW for PE with or without DVT and DVT only patients were 14.043±2.02%and 13.82±2.487%(p=0.258),respectively.4.CCI of 1-2 score was observed in 44.9%of the patients in PE with or without DVT and 19.2%in DVT only cases.CCI of>2 score was present in 17.4%in PE with or without DVT and 2.7%in DVT only cases.Similarly,78%of the population from DVT only group and 37.7%of the PE with or without group had no comorbidities.In 60-69 years age groups,the incidence rate of VTE by percentage was found to be 25.9%in PE with or without DVT and 23.9%in DVT only group.Among the eligible subjects,61.4%male and 38.6%female had PE with or without DVT,whereas 48.2%male and 51.8%female had DVT only.The most frequently associated comorbidities for PE with or without DVT were PI 161(50.156%),PVD 106(33.02%),HIN 105(32.71%),CTD 62(19.31%)and Uncomplicated DM 36(11.215%).In DVT only patients,commonly associated comorbidities were found to be PVD 43(16.863%),HTN 39(15.294%),uncomplicated DM 10(3.921%),surgery 10(3.921%)and solid tumor 7(2.745%).5.For the anatomical locations of the thrombi in PE with or without DVT patients,61.25%were located in the bilateral pulmonary arteries,26.25%in the right pulmonary artery and 12.5%in the left pulmonary artery.On further classification of the anatomical sites,53.27%were located in the main PA and 46.73%of the thrombi were found in the lobar,segmental and sub segmental arteries.On Comparing the sides of the thrombi involved in PE with the top comorbidities in our study,the thrombi evident in right side were associated with the 47.62%PI,40.48%PVD,29.76%HTN,15.48%CTD and 5.95%uncomplicated DM,respectively;in left side PE were associated with 57.50%PI,37.50%HTN,22.50%PVD,20%Uncomplicated DM and 15%CTD,respectively and in bilateral PE were found associated with 50%PI,33.16%HTN,32.14%PVD,22.63%CTD and 11.73%Uncomplicated DM,respectively in a descending order.In DVT only patients,deep vein thrombosis of left side was found to be 49.52%,on the right side was 33.89%and on the bilateral sides were 16.59%.Similarly,Femoral vein was affected in 225 cases,whereas in 34 cases Iliac vein was found affected.Conclusion:1.The incidence rate of VTE was higher but the mortality rate was found comparatively low in comparison to the most of the published articles,including the Western and the Asian population.2.The patients with PE with or without DVT had longer LOS in comparison to the DVT only patients.3.D-dimer and RDW levels in PE with or without DVT were found more than the DVT only patients.4.CCI score was relatively higher in PE with or without DVT patients in comparison to DVT only patients.Elderly age group was one of the commonest risk factors for VTE.The incidence of PE with or without DVT was higher in male patients but the female patients were more in DVT only Group.The top 5 comorbidities in PE with or without DVT were PI followed by PVD,HTN,CTD and Uncomplicated DM,whereas PVD was followed by HTN,uncomplicated DM,surgery and solid tumor in DVT only patients.5.The highest percentages of thrombi were located in the bilateral pulmonary arteries followed by the right and the left pulmonary arteries.On further classification of the anatomical sites,the thrombi were found located more in main PA than the lobar,segmental and sub segmental arteries.Comparing the sides involvement of PE with the top comorbidities in our study,the thrombus evident in right side were associated with the PI,PVD,HTN,CTD and uncomplicated DM,respectively;in left side PE were associated with PI,HTN,PVD,Uncomplicated DM and CTD,respectively and in bilateral sides,PE were associated with PI,HTN,PVD,CTD and Uncomplicated DM,respectively in a descending order.In case of DVT only patients,deep vein thrombosis of left side was found to be more in comparison to the right side and the bilateral sides.Similarly,Femoral vein was found to be more affected than the Iliac vein.