Risk factors for deep vein thrombosis in inpatients aged 65 and older: a case-control multicenter study.
OBJECTIVE
To identify independent risk factors of symptomatic deep vein thrombosis (DVT) in geriatric inpatients and to define high-risk patients likely to benefit from preventive treatment.


METHODS
Hospital-based case-control multicenter study with prospective data collection.


METHODS
Geriatric university hospitals with long-, intermediate-, and short-term care facilities.


METHODS
All patients aged 65 and older in 19 geriatric departments were submitted to clinical surveillance over a 16-month period.


METHODS
Twenty-three potential risk factors of phlebitis were screened for. Comparison using logistic regression of 310 consecutive patients with symptomatic DVT versus 310 randomly selected controls was performed. The risk for symptomatic DVT in geriatrics was then scored from the clinical risk factors identified using multivariate analysis. This score is defined by the sum of the odds ratio (OR) of each risk factor present.


RESULTS
Six factors were identified as independently related to the development of DVT: restriction of mobility (from OR=1.73, limited mobility without immobilization, to OR=5.64, bedridden during <15 days), aged 75 and older (OR=1.5/10 years), history of DVT or pulmonary embolism (OR=3.38), acute heart failure (OR=2.52), chronic edema of the lower limbs (OR=2.51), and paresis or paralysis of a lower limb (OR=2.06). The defined score of 8 or higher corresponded to an 88.7% probability of having symptomatic DVT.


CONCLUSIONS
Treatments to prevent symptomatic DVT in hospitalized elderly should be evaluated on patients with these factors.
Department of Geriatrics, Hôpital Rothschild, Paris, France.
Sébastien
S
Weill-Engerer
Sylvie
S
Meaume
Amina
A
Lahlou
François
F
Piette
Olivier
O
Saint-Jean
Annick
A
Sachet
Jean-Yves
JY
Beinis
Claude
C
Gallinari
Anne-Sophie
AS
Grancher
Jean-Pierre
JP
Vincent
Henri
H
Naga
Joel
J
Belmin
Rosella
R
Salvatore
Marie
M
Kazes
Eric
E
Pautas
André
A
Boiffin
Jean-Bernard
JB
Piera
Monique
M
Duviquet
David
D
Knafo
Andrée
A
Piau
Dragoslav
D
Miric
Alain
A
Jean
Valérie
V
Bellamy
Olivier
O
Tissandier
Alain-Ferdinand
AF
Le Blanche
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004487:Edema / Q000150:complications; D005260:Female; D006801:Humans; D007103:Immobilization; D007297:Inpatients; D008297:Male; D010243:Paralysis / Q000150:complications; D010689:Phlebitis / Q000209:etiology; D011655:Pulmonary Embolism / Q000150:complications; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology*