Postoperative major surgery patients developing silent deep vein thrombosis: A prospective observational study. 2018
Surgical patients are at high risk for developing deep vein thrombosis (DVT). There are many reports concerning DVT, but little is known about silent deep vein thrombosis (sDVT). This study aimed to determine the incidence of sDVT. Secondary objective is to identify the associated factors for the use of DVT prophylaxis and Caprini risk scores among major surgery patients. This prospective observational study involved postoperative surgical patients who are at risk of developing sDVT. The Caprini risk-assessment scores were calculated, and each subject had a preoperative and postoperative compression ultrasound complemented by duplex venous ultrasonography of deep venous system. No patient from the study experienced sDVT. There were significant associations between Caprini risk score group (odds ratio, 8.16; 95% confidence interval [CI], 1.01-68.74; P = .016) and the use of central venous catheter (odds ratio, 6.34; 95% CI, 1.62-24.80; P = .008) with DVT prophylaxis. Interestingly, the use of central venous catheter resulted in more than four-point increment of Caprini risk scores (mean increment, 4.19; 95% CI, 3.16-5.21; P < .001). Besides that, age was also significantly associated with Caprini risk scores (β coefficient, 0.06; 95% CI, 0.02-0.11). Result from our study shows that the sDVT was nonexistent in this study setting. High-Caprini risk score group and the presence of central venous catheter were the significant predictor factors for the use of DVT prophylaxis. Significant predictor factors for Caprini risk scores were age and the presence of central venous catheter.