Thromb Haemost 1993; 70(04): 576-578
DOI: 10.1055/s-0038-1649630
Original Article
Clinical Studies
Schattauer GmbH Stuttgart

Incidence and Course of Symptomatic Deep Venous Thrombosis of the Lower Extremities in a Black Caribbean Population

J C Nossent
1   The Department of lnternal Medicine, Willemstad, Curaçao, NetherlandS Antilles
,
N.C W.M Egelie
2   The Department of Surgery, St. Elisabeth Hospital, Willemstad, Curaçao, NetherlandS Antilles
› Author Affiliations
Further Information

Publication History

Received 19 November 1992

Accepted after revision 14 May 1993

Publication Date:
05 July 2018 (online)

Summary

During a 5-year period 131 patients with symptomatic deep venous thrombosis of the lower extremities (DVT) were identified in a black Caribbean population. Eighty-one patients (61%) had objective evidence (ascending venography), while in 39% the diagnosis was based on clinical findings only. The overall annual incidence rate for definite DVT was 11 per 100,000 person years; there was a steep increase with age in both sexes. Proximal DVT was present in 69% of patients. Swelling (92%), pain on palpation (89%) and tenderness (87%) were the most frequent symptoms, while immobilization (43%) and varicosities (42%) were the most frequent risk factors; DVT was rare during pregnancy (1 in 15,000 deliveries). Seventeen patients (21%) developed pulmonary embolism and five patients (6.2%) died during the hospital stay (four of fatal pulmonary embolism, one due to toxic epidermolysis after venography). We conclude, that symptomatic DVT of the lower extremities has a low incidence in this black Caribbean population, but is nonetheless associated with considerable morbidity and mortality due to pulmonary embolism.

 
  • References

  • 1 Kierkegaard A. Incidence of acute deep vein thrombosis in two districts: a phlebographic study. Acta Chir Scand 1980; 146: 267-269
  • 2 Coon WW. Epidemiology of venous thromboembolism. Ann Surg 1977; 186: 149-164
  • 3 Anderson FA, Wheeler HB, Goldberg RJ. et al. A population based perspective of the hospital incidence and case fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT study. Arch Intern Med 1991; 151: 933-938
  • 4 Tsapogas MJ, Venous thrombosis. Part I. Etiology, diagnosis and prevention. Ala J Med Sci 1987; 24: 176-181
  • 5 Hassan MA, Rahman EA, Rahman IA. Prostatectomy and deep vein thrombosis in Sudanese patients. Br J Surg 1974; 61: 650-652
  • 6 Hassan MA, Rahman EA, Rahman IA. Postoperative deep vein thrombosis in Sudanese patients. Br Med J 1973; 1: 515-517
  • 7 Thomas WA, Davies JN, O'Neal RM, Dimalkulagan AA. Incidence of myocardial infarction correlated with venous and pulmonary thrombosis and embolism. A geographic study based on autopsies in Uganda, East Africa and St. Louis, USA. Am J Cardiol 1960; 5: 41-47
  • 8 Gore I, Hirst AE, Tanaka K. Myocardial infarction and thromboembolism. A comparative study in Boston and Kyushu, Japan. Arch Intern Med 1964; 113: 323-328
  • 9 Cunningham IGE, Yong NK. The incidence of postoperative deep venous thrombosis in Malaysia. Br J Surg 1974; 61: 482-483
  • 10 Landefeld CS, McGuire E, Cohen AM. Clinical findings associated with acute proximal deep vein thrombosis: a basis for quantifying clinical judgement. Am J Med 1990; 88: 382-387
  • 11 Rabinov K, Paulin S. Roentgen diagnosis of venous thrombosis in the leg. Arch Surg 1972; 104: 134-144
  • 12 Centraal Bureau voor de Statistiek. Statistical Yearbook of the Netherlands Antilles 1990. Centraal Bureau voor de Statistiek, Willemstad 1990.
  • 13 Merskey. Gordon H, Lockner H. et al. Blood coagulation and fibrinolysis in relation to coronary heart disease. A comparative study in normal white men, white men with overt coronary heart disease and normal Bantu men. Br Med J 1960; 1: 219-25
  • 14 Koster T, Rosendaal FR, van der Meer FJM, Briët E, Vanden-broucke JP. More objective diagnoses of venous thromboembolism. Neth J Med 1991; 38: 246-248
  • 15 Rollins DL, Semrow CM, Friedeil ML, Lloyd WE. Origin of deep vein thrombi in an ambulatory population. Am J Surg 1988; 156: 122-125
  • 16 O'Donell TF, Abbott WM, Athanasoulis CA, Milan VG, Callow AD. Diagnosis of deep vein thrombosis in the outpatient by venography. Surg Gyn Obstet 1980; 150: 69-74
  • 17 Pollak JF, Wilkinson DL. Ultrasonographic diagnosis of symptomatic deep vein thrombosis in pregnancy. Am J Obstet Gynecol 1991; 165: 625-629
  • 18 Daerka D, Brown Y, Zelikovski A, Pinkhas J. Idiopathic deep venous thrombosis in an apparently healthy patient as a premonitory sign of occult cancer. Cancer 1986; 57: 1846-1849
  • 19 Voorhoeve R, Bruyninckx CMA, van Gerwen J, van den Borne H. The role of Doppler ultrasonography in the diagnosis of venous thrombosis: results in 100 patients examined consecutively. Ned Tijdschr Geneesk 1984; 128: 2297-2299
  • 20 Morrel MT, Dunmil MS. The postmortem incidence of pulmonary embolism in a hospital population. Br J Surg 1978; 65: 692-694
  • 21 Huisman MV, Buller HR, Ten Cate JW. et al. Unexpected high prevalence of silent pulmonary embolism in patients with deep venous thrombosis. Chest 1989; 95: 498-502
  • 22 Diebold J, Lohrs U. Venous thrombosis and pulmonary embolism. A study of 5039 autopsies. Pathol Res Pract 1991; 87: 260-266
  • 23 Salzman WE. Venous thrombosis made easy. N Engl J Med 1986; 314: 847-849