A revisit of venous thromboembolism

Abstract

Objective: To determine the effect of the introduction of Doppler ultrasonography to the management of venous thromboembolism in a health care facility in Nigeria. Method: A descriptive study of cases of venous thromboembolism (VTE) over a five-year period (March 2007-February 2012) was compared with a five-year review done two decades ago before the introduction of Doppler ultrasonography. Results: This review showed an increase of VTE cases from 60 to 178 with a median age of 53yrs, median age of female patients was 5yrs younger than male patients with Male/female ratio of 1:1.2. There was an even distribution of patients seen over the five-year period with a mean prevalence of 35.6 patients per year. Patients with distal deep vein thrombosis (DVT) were in the majority (76%) compared with proximal DVT and PE which were 21% Vs 3%. About 4% of the patients had a recurrence of the VTE with male patients having twice the likelihood of a re-thrombosis. Common comorbid states observed are cerebrovascular disease (14.5%), cancers (12.2%), retroviral disease (6.7%) and diabetes (6.2%). Prostatic cancer was more common than other cancers while patients with retroviral disease are more likely to have an extensive DVT. Conclusion: The introduction of Doppler ultrasonography increased the awareness and diagnosis of VTE, we suggest that patients with associated disease conditions are placed on prophylactic anticoagulation, it is also necessary to determine the prevalence of inherited causes of VTE in the population.