Cook et al identified risk factors for deep venous thrombosis (DVT) in a patient in the intensive care unit (ICU). This can help identify patients who may require closer monitoring and more aggressive management. The authors are from McMaster University and the University of Toronto in Ontario, Canada.


Patient selection: adult medical or surgical patients expected to be in ICU >= 3 days. Note that the average APACHE II score for enrolled patients was 25.5 and almost 40% died in the hospital.


Risk factors for deep vein thrombosis found to be independent on multivariate analysis:

(1) personal or family history of venous thromboembolism

(2) chronic hemodialysis in end-stage renal failure

(3) platelet transfusion

(4) use of vasopressors


Deep vein thrombosis in the lower extremities occurs in ICU patients despite thromboprophylaxis. Failure to give thromboprophylaxis would further increase the risk.


Monitoring of the patient should continue after discharge from the ICU.


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