RAVS Study: One Indian Single Center Analysis of Patients with VTE

Abstract

Objective : Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE affects all races, age groups, and genders. The objective of this registry was to analyze the patient characteristics, clinical outcomes, management strategies, and temporal trends in VTE at a single center. Materials and Methods : Consecutive medical records of inpatients between January 2007 and March 2018, meeting the inclusion criteria (confirmed diagnosis of DVT by Doppler ultrasound scan and/or PE by chest computed tomography) were identified and collected. A total of 1,024 patients were reviewed. Results : Eight hundred and twelve patients with VTE were enrolled into the study; 37.4% were referrals from outside hospitals, 33.1% of the total patients had no risk factors, hence classified as unprovoked VTE and the rest of the patients had single or multiple risk factors which may have provoked the VTE, 68.8% presented with swelling and pain, and 88.5% had proximal DVT. Conclusion : VTE is no longer a rare phenomenon in the Indian population, as believed earlier. The knowledge of VTE, prophylaxis, and treatment strategies is minimal among small institutes, nursing homes, and among general practitioners who are not affiliated with teaching institutes. Therefore, educating primary care physicians/surgeons on VTE is paramount, as this would reduce the incidence of VTE in India as well as associated morbidity and mortality rates.

A review of venous thromboembolism risk assessment models for different patient populations: What we know and don’t!

“…In summary, although several validated RAMs have been developed globally for different patient populations and conditions, to facilitate early diagnosis and prophylaxis for VTE, systematic efforts to identify patients at risk of VTE by utilizing appropriate RAMs in India needs to be strengthened. [ 12 ] Further, since some of the risk factors for VTE predisposition are markedly different in the Indian population, as compared to the Western counterparts, there is also an unmet need of large-scale multicenter validation studies for existing RAMs. [ 13 , 15 , 17 , 18 ] Nevertheless, routine implementation of available RAMs for VTE risk assessments in different patient populations and their appropriate use in the Indian population is the need of the hour.…”

“…[13] The limited existing studies on the incidence of VTE in India indicate that in contrast to the previous perception, VTE is no more a rare phenomenon in the country. [12] This initiative was supported by Sanofi India. Medical writing related charges were paid for by Sanofi India.…”

“…Qualitative/group models for VTE risk assessment These models assign a group of patients to broad risk categories that are linked to appropriate prophylaxis options for Table 1 Risk factors for venous thromboembolism. [1,5,10,[12][13][14]19,20]…”

“…[ 10 ] The DETECT-DVT registry reported a 3.2% incidence of DVT in Indian acute sepsis patients not receiving thromboprophylaxis. [ 11 ] In the RAVS [ 12 ] study which was a single center retrospective study, the reported incidence rate of VTE was 14.2 per 100,000 admissions. The christian medical college Vellore study however reported an incidence of 17.4 VTE patients per 10,000 admissions.…”

“…[ 13 ] The limited existing studies on the incidence of VTE in India indicate that in contrast to the previous perception, VTE is no more a rare phenomenon in the country. [ 12 ]…”