title: Risk factors for mortality in patients with upper extremity and internal jugular deep venous thrombosis.
abstract: OBJECTIVE
  To elucidate the natural history of upper extremity deep venous thrombosis (UEDVT), we examined factors that may contribute to the high mortality associated with UEDVT.
  
  
  METHODS
  Five hundred forty-six patients were diagnosed with acute internal jugular/subclavian/axillary deep venous thrombosis from January 1992 to June 2003 by duplex scanning at our institution. There were 329 women (60%). The mean age +/- SD was 68 +/- 17 years (range, 1-101 years). Risk factors for UEDVT were the presence of a central venous catheter or pacemaker in 327 patients (60%) and a history of malignancy in 119 patients (22%). Risk factors for mortality within 2 months of the diagnosis of UEDVT that were analyzed included age, sex, presence of a central venous catheter or pacemaker, history of malignancy, location of UEDVT, concomitant lower extremity deep venous thrombosis, systemic anticoagulation, placement of a superior vena caval filter, and pulmonary embolism.
  
  
  RESULTS
  The overall mortality rate at 2 months was 29.6%. The number of patients diagnosed with pulmonary embolism by positive ventilation/perfusion scan or computed tomographic scan was 26 (5%). The presence of a central venous catheter or pacemaker ( P < .001), concomitant lower extremity deep venous thrombosis ( P = .04), not undergoing systemic anticoagulation ( P = .002), and the placement of a superior vena caval filter ( P = .02) were associated with mortality within 2 months of the diagnosis of UEDVT by univariate analysis. Pulmonary embolism ( P = .42), sex ( P = .65), and a history of malignancy ( P = .96) were not.
  
  
  CONCLUSIONS
  These data suggest that the high associated mortality of UEDVT may be due to the underlying characteristics of the patients' disease process and may not be a direct consequence of the UEDVT itself.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA.
authors.forename: Anil
authors.initials: A
authors.lastname: Hingorani
authors.forename: Enrico
authors.initials: E
authors.lastname: Ascher
authors.forename: Natalia
authors.initials: N
authors.lastname: Markevich
authors.forename: William
authors.initials: W
authors.lastname: Yorkovich
authors.forename: Richard
authors.initials: R
authors.lastname: Schutzer
authors.forename: Manikyam
authors.initials: M
authors.lastname: Mutyala
authors.forename: Suresh
authors.initials: S
authors.lastname: Nahata
authors.forename: Theresa
authors.initials: T
authors.lastname: Jacob
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D034941:Upper Extremity / Q000098:blood supply*; D020246:Venous Thrombosis / Q000453:epidemiology / Q000401:mortality*