Risk Factors Of Lower Extremity Deep Vein Thrombosis In Different Locations And Their Correlation With Pulmonary Embolism

Background: the intermuscular venous plexus of the leg is a common site of deep venous thrombosis(lower extremity deep venous thrombosis,LEDVT)of the lower extremities.Because the lumen of the intermuscular vein of the leg is slender and communicates with the deep and superficial veins of the lower extremities,it is easy to establish a blood flow bypass,which is usually hidden,the scope of the lesion is small,and the clinical symptoms are generally not obvious.sometimes it may not be found,diagnosed and treated early because of the lack of clinical symptoms.In severe cases,it can extend to the deep veins of the proximal lower extremities and cause fatal pulmonary embolism(pulmonary embolism,PE).At present,there are few reports about the risk factors of LEDVT in different sites,and the correlation between the occurrence of PE has not been clearly elucidated.The purpose of this study is to explain the risk factors of LEDVT in different sites and to improve its prognosis.Objective: the purpose of this study was to explore the risk factors of LEDVT in different parts of adult patients and the correlation between the occurrence of PE.Methods: the clinical data of patients aged 18 and over diagnosed as LEDVT firstly by color doppler ultrasound(color doppler flow imaging,CDFI)in Qingdao Municipal Hospital from January 2019 to December 2019 were collected retrospectively.The sex,age,smoking history,recent trauma history,nearly 4 months operation history,common cardio-cerebrovascular disease history(including hypertension,coronary heart disease,atrial fibrillation,cerebral infarction),other basic diseases(such as diabetes,malignant tumor)and hyperlipidemia were recorded in detail.According to the vein of LEDVT,the patients were divided into two groups: isolated calf muscle venous thrombosis(isolated calf muscle venous thrombosis,ICMVT)group and other deep vein thrombosis group.The risk factors of LEDVT in different parts of LEDVT were discussed,and the correlation of PE in patients with different parts of DVT was analyzed.95 cases of lower limb LEDVT were excluded,and the remaining 316 patients were divided into two groups according to the location of LEDVT:single left group and single right group,to explore the risk factors of left and right lower limb LEDVT and the correlation of PE.Results: 1.A total of 411 adult patients with LEDVT were enrolled in this study,including184 males and 227 females,aged from 22 to 97 years old,with an average age of 70 years.There were 179 cases of ICMVT(43.6%)and 232 cases of other deep vein thrombosis(56.4%).Pearson chi-square test showed that the location of LEDVT was correlated with age,hypertension,coronary heart disease and cerebral infarction,and the location of LEDVT was significantly related to the occurrence of PE.The location of LEDVT may not be correlated with sex(P=0.153),smoking history(P=0.263),trauma history(P=0.366),operation history(P=0.190),atrial fibrillation(P=0.886),hyperlipidemia(P=1.000),diabetes(P=0.275)and malignant tumor(P=0.985).3.95 patients with LEDVT of both lower limbs were excluded.The remaining 316 patients with LEDVT were divided into single left group and single right group according to the location of thrombosis.Pearson chi-square test was used to analyze the difference between groups.There were 175 patients with recent history of trauma in single left group,accounting for 55.4%,and 141 patients with recent history of trauma in single right group,accounting for 44.6%.The comparison between the two groups was statistically significant.The results showed that patients with recent history of trauma had a higher risk of developing left LEDVT,but there was no significant correlation between age(0.357),sex(P=0.066),smoking(P=0.515),recent 4 months of operation(P=0.312),hypertension(P=0.360),coronary heart disease(P=0.447),atrial fibrillation(P=0.581),cerebral infarction(P=0.347),diabetes(P=0.949),malignant tumor(P=0.319)and hyperlipidemia(P=0.632).The risk of developing PE in patients with left LEDVT was not higher than that in patients with right(P=0.428).4.Univariate analysis showed that age,hypertension,coronary heart disease and cerebral infarction were related to the location of LEDVT.The statistically significant factors of the two groups were included in the multivariate binary Logistic regression model.The location of LEDVT was taken as the dependent variable and the above factors as covariates for multivariate analysis.The results showed that there was a strong independent correlation between the location of LEDVT in adult patients and age(HR=0.982,95%CI: 0.966-0.998),but there was no significant difference between the two groups with or without hypertension,coronary heart disease and cerebral infarction.Conclusions: Age is an independent risk factor for LEDVT in different parts of adult patients.The incidence of ICMVT is lower than that of deep venous thrombosis in other parts,and the risk of thrombus shedding is relatively small.The incidence rate of left LEDVT is higher than that of the right side,but patients with right LEDVT may have a higher risk of developing PE than patients with left LEDVT.