Deep Venous Thrombosis Prophylaxis Practices in Surgical Intensive Care Unit Patients: A Cross-sectional Study

Abstract

Introduction: Deep Venous Thrombosis (DVT) is one of the critical complications which can occur in patients subsequent to surgeries. The patients in Surgical Intensive Care Units (SICU) have increased propensity to have DVT due to prolonged immobilisation, invasive interventions and other risk factors. It is important to prevent DVT as this can lead to catastrophic Pulmonary Embolism (PE) and balance the risk of haemorrhages due to pharmacotherapy. Aim: To observe the DVT prophylaxis methods and to compare the incidence of DVT in the different methods used in SICU. Materials and Methods: The present study was a prospective cross-sectional study in which 62 patients, aged between 18-70 years admitted in SICU for more than or equal to two days, were included in the study. Patients on drugs affecting cardiovascular system and having significant co-morbidities and coagulation abnormalities, that can impact the occurrence of DVT, were excluded. All patients were followed-up till 28 days or ICU discharge, whichever was later. Patients were evaluated for type of prophylaxis for DVT that included any of mechanical interventions {such as stockings or Sequential Compression Devices (SCD)} or pharmacotherapy (Low molecular weight heparin or Unfractionated heparin) or a combination of both. Statistical analysis was carried out using Student’s t-test and Chi-square test. Results: Thirty (48.39%) patients were given both mechanical and pharmacotherapy, 12 (19.35%) had used only mechanical interventions and 20 (32.26%) had used pharmacotherapy alone for DVT prophylaxis. The overall incidence of DVT was 3.33% (one patient) for patients receiving both mechanical and pharmacotherapy whereas it was 10% (two) for those receiving pharmacotherapy alone and 16.67% (two) for those using mechanical intervention alone. Incidence of haemorrhage was highest in pharmacotherapy alone {three patients (15%)}. The overall dose of drugs used as pharmacotherapy was the least in those receiving dual interventions compared to that of patients receiving pharmacotherapy alone. Conclusion: Pharmacotherapy and pressure stockings together are an ideal therapy for DVT prophylaxis.