Clinical Features of Lower Extremity Deep Venous Thrombosis in Elder Patients

HE Jing; WANG Jun; YANG Tao

doi:10.3969/j.issn.1002-3429.2018.07.003

Abstract：Objective To analyze the clinical characteristics of lower extremity deep venous thrombosis ( LDVT) in elderly patients, treatment and management of elderly patients with LDVT. Methods The demographic and clinical data of 469 elderly patients with LDVT admitted to Department of Vascular Surgery of our hospital during the period from June 2012 to June 2017 were collected and analyzed retrospectively, and the clinical characteristics of all patients were analyzed. The differences in clinical characteristics of LDVT in patients <80 years old and ≥80 years old were compared. Results The ratio of male to female was approximately the same in 469 patients, with a median age of 74 years, including 104 cases (22. 2% ) aged≥80 years, and 85 cases (18. 2% ) of pulmonary em-bolism (PE). DVT was most commonly found in left lower limb was the most common (51. 0% ), mainly in acute phase (70. 2% ) and predominantly involving mixed type (46. 5% ) and peripheral type (42. 9% ). Femoral vein, intermuscular vein, popliteal vein were mostly involved. The main symptoms and signs of patients were swelling and pain of the affected limbs. In addition, 77. 6% of the patients had risk factors for thrombosis, 17. 9% of whom had more than 3 risk factors. The top six risk factors were hypertension, surgical immobility, fracture injury, diabetes mellitus, stroke/paralysis/long-term bed rest, and malignant tumor. The proportion of LDVT in the bilateral lower limbs was higher and hypertension and fracture injuries were more common in the≥80-year-old group, compared to the <80-year-old group. Conclusion Identification of pathological and clinical characteristics in elderly patients with LDVT is essential for their treatment and management. Older patients are more likely to be affected in bilateral lower limbs, and hypertension and fracture injuries are more common in all risk factors. Therefore, in the screening, prevention and treatment of elderly people, attention should be paid to both limbs in meantime. Moreover, it is also important to put a high value on screening for thrombosis in elder patients with hypertension and after fracture injury.