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SS17. Midterm Outcomes in Patients With Upper Extremity Deep Venous Thrombosis
Abstract   Open access   Peer reviewed

SS17. Midterm Outcomes in Patients With Upper Extremity Deep Venous Thrombosis

Ashlei C. Beiswenger, Humzah Quereshy, Mohamed Rouabhi, Anas Abdel Azim, Matthew Janko, Andrew Shevitz, Saideep Bose and Vikram S. Kashyap
Journal of vascular surgery, Vol.69(6), pp.e192-e193
06/2019
DOI: 10.1016/j.jvs.2019.04.274
url
https://doi.org/10.1016/j.jvs.2019.04.274View
Published (Version of record) Open Access

Abstract

Objective The incidence of deleterious outcomes of and the need for anticoagulation in patients with upper extremity deep venous thrombosis (UE DVT) are unclear. The purpose of this study was to determine the incidence of UE DVT, the outcomes with and without anticoagulation treatment, and which factors are significant in predicting mortality. Methods This study was a single-center retrospective review of all patients diagnosed with UE DVT in 2016. Information on patients' demographics, relevant comorbidities, use of anticoagulation at the time of diagnosis, characteristics of the UE DVT, treatment regimen, and outcomes was collected. Data were analyzed on an intention-to-treat basis by multivariate logistic regression models predicting mortality rates at 30 days and 6 months using the aforementioned covariates at a 95% confidence level. Results Of the 911 patients undergoing upper extremity venous duplex ultrasound, 182 (20.0%) were positive for UE DVT. Within the first 30 days, 30 (16.5%) of these patients died and 13 (7.1%) had pulmonary emboli. Of those who had pulmonary emboli, two died. Within the first 6 months, a total of 50 (27.5%) patients died. The mortality rate at 30 days was found to be significantly increased in patients who were older (odds ratio [OR], 1.06; P < .001) and had high-risk contraindications to anticoagulation (OR, 5.12; P < .01) and significantly decreased in patients who were treated with anticoagulation (OR, 0.13; P = .02; Table). At 6 months, however, only older age (OR, 1.05; P = .02) and cancer at the time of diagnosis (OR, 8.81; P < .001) were found to significantly increase the risk of death. Conclusions These preliminary data suggest that mortality rates among patients with UE DVT are relatively high (27.1% in the first 6 months), but rates of pulmonary emboli are relatively low (7.1%). Treatment with anticoagulation significantly reduces the risk of death in the short term, but this may be due to mechanisms different from pulmonary embolism prophylaxis.

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