Venous thrombo-embolism in India

Abstract

Introduction: Venous thrombo-embolism (VTE) has traditionally been considered rare in Asia. Recent reports from Hong Kong and Singapore indicate an increasing incidence of VTE.

Objectives: To determine the incidence of VTE among hospitalised patients and study the predisposing factors and hence to increase the awareness of the need for VTE prophylaxis.

Methods: This is a retrospective study carried out on all patients diagnosed with VTE between 1996 and 2005 at our hospital. In-patient records were used to collect data while out-patient records were used for follow-up outcomes.

Results: The incidence of VTE was 17.46 per 10,000 admissions. Malignancy (31%) was the most common predisposing factor, followed by postoperative status (30%). The incidence following surgery was five per 10,000 operations. General surgery patients had the highest incidence of deep vein thrombosis (DVT; 40.3%), while the incidence in orthopaedic patients was 20.1%. Low-molecular-weight heparin (LMWH) has been increasingly used therapeutically over the years. Pulmonary embolism was diagnosed in 14.9% of the study patients. Mortality in those with confirmed pulmonary embolism was 13.5%.

Conclusion: VTE is no longer a rarity in India. General surgical operations are the most common causes of postoperative DVT. Pulmonary embolism continues to be 'suspected' more often than it is diagnosed.