ABSTRACT
BACKGROUND AND OBJECTIVE: The incidence and risk factors for the development of post-thrombotic syndrome (PTS) are not well known, so the aim of our study is to evaluate the development of PTS after proximal deep vein thrombosis (DVT) and its relationship with several clinical, laboratory and therapeutic factors. PATIENTS AND METHOD: Prospective, observational study. INCLUSION CRITERIA: consecutive patients with acute symptomatic proximal DVT in the lower extremities diagnosed between February 2000 and July 2002. EXCLUSION CRITERIA: life expectancy < 12 months, impossibility for follow-up, renal or hepatic failure, previous PTS or varicosis and recurrent thrombosis during follow up. Endpoint: PTS at 12 months. Explicative variables: clinical risk factors for DVT, D-dimer value, hypercoaguable state, anticoagulant therapy and compression stockings compliance. Multivariable analysis (logistic regression) was performed. RESULTS: One hundred and seventy two patients with DVT were evaluated for inclusion. Sixty nine were excluded and 87 patients completed follow-up. PTS appeared in 47 patients (54%). Compliance of compression stockings was adequate in 57% of patients and decreased 45% the risk for PTS (p = 0.01). No significant associations were observed between PTS and others variables. Multivariable analysis confirmed the protective effect of compression stockings (RR = 0.3; p < 0.01) and previous ipsilateral DVT appeared significatively associated with PTS development (RR = 8; p = 0.01) CONCLUSIONS: About 50% of patients with proximal DVT develop PTS within 1 year. Previous ipsilateral DVT is the strongest risk factor for PTS. Regular compression stocking use decreases the risk of PTS by 50%.
Subject(s)
Postphlebitic Syndrome/epidemiology , Venous Thrombosis/epidemiology , Aged , Female , Humans , Male , Middle Aged , Multivariate Analysis , Postphlebitic Syndrome/therapy , Prospective Studies , Risk Factors , Venous Thrombosis/therapyABSTRACT
Fundamento y objetivo: La incidencia y los factores de riesgo para el desarrollo de síndrome postrombótico (SPT) no son bien conocidos. El objetivo del estudio fue determinar la relación entre el SPT y determinadas variables clínicas, analíticas y terapéuticas. Pacientes y método: Estudio prospectivo observacional. Se incluyó consecutivamente a pacientes con trombosis venosa profunda (TVP) proximal de miembros inferiores atendidos en medicina interna entre febrero de 2000 y julio de 2002. Se excluyó a aquellos con esperanza de vida inferior a 12 meses, imposibilidad de seguimiento, insuficiencia hepática o renal, SPT o varices previos y recurrencia de la trombosis durante el seguimiento. La variable principal fue el desarrollo de SPT a los 12 meses y las variables explicativas, los factores de riesgo de TVP, el valor del dímero D, los estudios de hipercoagulabilidad, el tratamiento anticoagulante y el uso de medias elásticas compresivas. Resultados: Se evaluó a 172 pacientes con TVP, de los cuales se excluyó a 69 y 16 se perdieron en el seguimiento. De los 87 pacientes que completaron el estudio, 47 (54%) desarrollaron SPT. La utilización de medias compresivas fue correcta en el 57% y se asoció a un descenso de la incidencia de SPT del 45% (p = 0,01). Ninguna otra variable se asoció a SPT. El análisis multivariante confirmó el efecto protector de las medias compresivas (riesgo relativo de 0,3; p < 0,01) y además identificó como factor de riesgo independiente de SPT el antecedente de TVP ipsolateral (riesgo relativo de 8,8; p = 0,01) Conclusiones: Aproximadamente el 50% de los pacientes con TVP desarrolla SPT al año. El riesgo es mayor en pacientes con TVP previa ipsolateral y disminuye a la mitad con la utilización de medias compresivas
Background and objective: The incidence and risk factors for the development of post-thrombotic syndrome (PTS) are not well known, so the aim of our study is to evaluate the development of PTS after proximal deep vein thrombosis (DVT) and its relationship with several clinical, laboratory and therapeutic factors. Patients and method: Prospective, observational study. Inclusion criteria: consecutive patients with acute symptomatic proximal DVT in the lower extremities diagnosed between February 2000 and July 2002. Exclusion criteria: life expectancy < 12 months, impossibility for follow-up, renal or hepatic failure, previous PTS or varicosis and recurrent thrombosis during follow up. Endpoint: PTS at 12 months. Explicative variables: clinical risk factors for DVT, D-dimer value, hypercoaguable state, anticoagulant therapy and compression stockings compliance. Multivariable analysis (logistic regression) was performed. Results: One hundred and seventy two patients with DVT were evaluated for inclusion. Sixty nine were excluded and 87 patients completed follow-up. PTS appeared in 47 patients (54%). Compliance of compression stockings was adequate in 57% of patients and decreased 45% the risk for PTS (p = 0.01). No significant associations were observed between PTS and others variables. Multivariable analysis confirmed the protective effect of compression stockings (RR = 0.3; p < 0.01) and previous ipsilateral DVT appeared significatively associated with PTS development (RR = 8; p = 0.01) Conclusions: About 50% of patients with proximal DVT develop PTS within 1 year. Previous ipsilateral DVT is the strongest risk factor for PTS. Regular compression stocking use decreases the risk of PTS by 50%
Subject(s)
Male , Female , Aged , Middle Aged , Humans , Venous Thrombosis/complications , Thrombophilia/complications , Risk Factors , Prospective Studies , Recurrence/prevention & control , Bandages , Hypertension/complications , Hyperhomocysteinemia/complicationsSubject(s)
Neoplasms/complications , Venous Thrombosis/complications , Aged , Female , Humans , Male , Neoplasms/epidemiology , Recurrence , Risk Factors , Venous Thrombosis/epidemiologyABSTRACT
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Subject(s)
Aged , Aged, 80 and over , Male , Female , Humans , Risk Factors , Ticlopidine , Treatment Outcome , Platelet Aggregation Inhibitors , Recurrence , Venous Thrombosis , Chemical and Drug Induced Liver Injury , Neoplasms , Liver Function TestsABSTRACT
FUNDAMENTO: Analizar la prevalencia de infección oculta por los virus de la hepatis B (VHB) y C (VHC), de la inmunodeficiencia humana (VIH) e infección tuberculosa en usuarios de drogas en tratamiento sustitutivo con metadona (TSM). PACIENTES Y MÉTODO: Se realizó serología VHB, VHC, VIH y prueba de Mantoux a 189 usuarios de drogas. Se recogieron antecedentes de drogadicción y vía de consumo. RESULTADOS: Los datos de la prevalencia observada fueron: VIH, 29,2 por ciento; VHC, 75,9 por ciento; infección tuberculosa, 59,3 por ciento. La vía parenteral, una inclusión tardía en el TSM y un inicio temprano en el consumo de heroína se asociaron a infección por el VIH y VHC. CONCLUSIONES: Existe una alta prevalencia de infección tuberculosa y VHC en usuarios de drogas. Un acceso temprano al TSM podría disminuir esta prevalencia (AU)
