January 1-December 31, 2014
Background: Venous thromboembolic (VTE) disease is one of the three major cardiovascular causes of death, along with myocardial infarction and stroke. Among hospitalized patients, it is a common disorder that constantly poses a significant morbidity and mortality risks. This registry aims to create a comprehensive database regarding the clinical characteristics of Filipino patients with ultrasound-confirmed deep venous thrombosis (DVT), their clinical symptoms or manner of presentation, the associated risk factors and initial management given.
Method: This is a retrospective descriptive study. From 2003 to 2013, all patients admitted at the Philippine Heart Center (PHC) with ultrasound-confirmed DVT were included in the study.
Results: In a total of 184 patients included in the registry, 45% of the participants were men. The mean age of presentation of patient was 58 years, ranges 20 to 97 years. They commonly present with extremity swelling or edema (65%), while others manifests with dyspnea (22%) and chest pain (10%). In 74% of cases, recent surgery in the past 3 months is the most common initiator. No obvious cause was found for I case of DVT. As compared to Caucasians, the most frequent co-morbidities documented in Filipino patients were hypertension (67%), coronary artery disease (35%) and diabetes mellitus (32%). The physician initiated anticoagulation in 95.7% of cases. Unfractionated heparin was given in 83% (n=146) of cases and low molecular weight heparin (LMWH) was given in 5% (n= 10). Maintenance oral anticoagulant (warfarin) was prescribed in 148 cases (80%). Among patients receiving treatment, there were nine documented deaths (5%) and one death (13%) was documented among those who did not receive any treatment.
Conclusion: This registry concluded that the risk of DVT was high in acutely ill patients admitted at PHC. Data showed that only 0.5% (n= 1) of identified DVT cases have no obvious cause or contributing factor found. On the other hand, differences in the classical risk factors noted among Caucasian counterparts were noted. In particular, local data documented that elderly patients with diabetes mellitus are at higher risk of developing DVT, compared to younger patients as stated in internationally established data. With regards to diagnosis, venous ultrasound was the most frequently requested investigation. The treatment being given by our local cardiologists reflects their remarkable compliance with the management of DVT in accordance to the current international practice guidelines.