Predictable Risk Factors of Upper-Extremity Deep Venous Thrombosis in a Level I Trauma Center

Int J Gen Med. 2021 Jun 18:14:2637-2644. doi: 10.2147/IJGM.S311669. eCollection 2021.


Background: Venous thromboembolism is a common cause of morbidity and mortality in hospital patients, especially that of the lower extremities. Risk factors and diagnostic elements of upper-extremity deep-vein thrombosis (UEDVT) are poorly understood compared to those of the lower extremities. The primary objectives of this study were to identify predictive risk factors of secondary UEDVT.

Methods: This retrospective study included all nonpregnant patients aged >18 years who had undergone upper-extremity duplex scans to check for the presence of secondary UEDVT at Richmond University Medical Center from January 2014 to March 2020. Patients were stratified by presence or absence of UEDVT. Collected data points included patient demographics, comorbidities, central-line use, platelet count at time of scan, length of stay, and overall mortality. IBM 27.0 was used for all statistical analysis, with p<0.05 considered significant.

Results: A total of 1,009 upper extremity venous duplex studies were included. There were no significant differences in age, sex, race, or mean platelet levels between patients diagnosed with DVT and those without (p<0.05). After multinomial regression analysis, central venous catheter (CVC; 26.8% versus 78.5%, aOR 1.770, 95% CI 1.150-2.725; p<0.002), peripherally inserted central catheter (PICC) line (17.5% versus 82.5%, aOR3.254, 95% CI 1.997-5.304; p<0.001), hypertension (67.8% versus 28.8%, aOR 1.641, 95% CI 1.136-2.369; p<0.001), chronic kidney disease (CKD; 34.5% versus 65.5%, aOR 1.743, 95% CI 1.201-2.531; p<0.001), and malignancy (27.1% versus 74.6%, aOR 1.475, 95% CI 0.994-2.190; p<0.053) were found to be independent predictors of UEDVT.

Conclusion: Use of CVC or PICC line, preexisting diagnosis of hypertension, malignancy, and CKD were independent risk factors of UEDVT, while there was no significant correlation between increased platelet levels and UEDVT.

Keywords: deep-vein thrombosis; risk factors; thrombocytosis; thromboembolism; upper extremity.