Risk Factors For Deep Venous Thrombosis In Lower Extremity In ICU Patients

Objective:Patients in Intensive Care Units(ICU)have an increased risk of Deep Venous Thrombosis(DVT),and due to the influence of factors such as endotracheal intubation,sedation and analgesia,the clinical manifestations of DVT are often atypical,making it difficult to identify.Since the physiological reserves of severely ill patients are severely impaired,the risk of poor prognosis after DVT is also higher.In this study,risk factors for Lower Extremity Deep Venous Thrombosis(LEDVT)in ICU patients were analyzed to provide a basis for preventative treatment of DVT in various specialties and ICU.Methods:A total of 147 patients admitted to the ICU in building 3 of the first affiliated hospital of kunming medical university from June 2019 to March 2020 were selected as the sample population.According to the inclusion criteria and exclusion criteria,131 patients were selected as the final study subjects.Ultrasound examination of lower extremity blood vessels was performed within 24 hours after admission.According to the presence or absence of thrombosis,the subjects were divided into 32 patients in the thrombus group(group A)and 99 patients in the non-thrombus group(group B).Eight patients in group B who were discharged or died without a second ultrasound examination were excluded,The remaining patients in group B continued to receive bedside ultrasound examination(once a week until deep venous thrombosis of lower extremity was detected or the patients were discharged or died),according to the presence or absence of new thrombosis,35 patients were divided into the new thrombosis group(B1 group)and 56 patients were divided into the non-new thrombosis group(B2 group).We collect the research object of the general clinical data,BMI(Body Mass Index,BMI),Acute physiology And Chronic Health Evaluation system ?(Acute Myocardial And Chronic Health Evaluation,APACHE?)score,smoking status,basic diseases,blood type,laboratory testing results,treatment conditions and related information.Risk factors for deep vein thrombosis in lower extremity outside ICU were compared between group A and group B,Risk factors for deep venous thrombosis in lower extremity in ICU were compared between group B1 and group B2.Spss17.0 statistical software was used to calculate the correlation between various factors and LEDVT by using ?2 test,t test and logistic logistic multivariate regression analysis.P value less than 0.05 was statistically significant.Results:1.The incidence of LEDVT at admission was 24.4%,and that in ICU was 38.5%.The proportion of thrombosis on the left side was higher than that on the right side,and peripheral thrombosis accounted for the highest proportion.Thrombus formation often lacks typical clinical manifestations.2.Analysis of relevant risk factors:Comparison between the two groups A and B:smoking,obesity,malignant tumor,previous history of VTE,history of stroke,history of kidney disease,and age were statistically significant.The results of logistic regression analysis showed that age,obesity,smoking and previous history of VTE were risk factors for thrombosis.Comparison between groups B1 and B2:Smoking,obesity,hypertension,diabetes,history,medical history,history of stroke,COPD,sepsis,age,blood type APACHE II score,red blood cell count,erythrocyte deposited,neutrophils-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),D-dimer,C-reactive protein(CRP),central venous catheter indwelling time,mechanical ventilation time,braking time difference were statistically significant.The results of logistic regression analysis showed that smoking,diabetes,sepsis,braking time and non-anticoagulant therapy were the risk factors for thrombosis.Conclusion:1.The incidence of LEDVT in ICU patients is high,the proportion of thrombosis on the left side is higher than that on the right side,and the peripheral type accounts for the highest proportion of thrombosis,among which the calf intermuscular vein thrombosis is the most common,and the typical clinical manifestations are often absent after thrombosis.2.Studies have shown that age,obesity,smoking,and previous HISTORY of VTE are risk factors for LEDVT in ICU,while smoking,diabetes,sepsis,braking time,and non-anticoagulant therapy are risk factors for LEDVT in ICU.