The anatomical distribution and pulmonary embolism complications of hospital-acquired lower extremity deep venous thrombosis

Abstract Objectives The anatomic distribution of lower extremity deep venous thrombosis (LEDVT) plays an important role in its prevention and treatment. This study aimed to evaluate the anatomic distribution of hospital-acquired LEDVT (HA-LEDVT) and its probable role in occurrence of PE. Methods We retrospectively analyzed the demographic data, ultrasound results, and pulmonary embolism (PE)-related findings of inpatients with HA-LEDVT in 28 clinical departments at Peking University People’s Hospital between January 1, 2007 and December 31, 2018. Results This study included 1,431 HA-LEDVT events: 35.8%, 31%, and 33.3% were left, right, and bilateral LEDVT. Isolated distal, proximal, and blended DVT were detected in 83.4%, 7.3%, and 9.3% of the patients, respectively. The distribution of HA-LEDVT in left and right lower extremities were not significantly different except in patients aged ≥40 years (left:2.07 vs right:1.88 per 1,000 extremities, P=0.04). For anatomic types of HA-LEDVT, isolated distal HA-LEDVT was 5.02 times more prevalent than proximal HA-LEDVT (1.24 vs 0.26 per 1,000 extremities, P 6.05-mm-diameter thrombus than in those with Conclusions HA-LEDVT is characterized by a significantly high percentage of DVT in muscular calf vein. Muscular calf vein thrombosis may be the primary origin of lower extremity deep vein thrombosis. Diameter of thrombus in muscular calf vein may be associated with the occurrence of PE. More prospective studies are needed to more fully determine the natural history of HA-LEDVT and develop prevention and treatment guidelines for HA-LEDVT.