Results
Populations characteristics: During the study period, 300
patients were referred to the hematology department from the internal
medicine department for IT screening. after exclusion of patients with
missing clinical data, 190 patients were included (Figure 1).
Demographic and clinical characteristics of patients are summarized in
table 1.
Index venous thrombotic event: Thrombosis sites were proximal
deep venous thrombosis of lower limbs (52.5%), pulmonary embolism
(12.6%), both proximal deep venous thrombosis of lower limbs and
pulmonary embolism (7.9%), distal deep venous thrombosis of lower limbs
(19%), superficial venous of lower limbs (7.4%), unusual sites
(14.9%). the thrombotic event was secondary to a persistent risk factor
(6%), transient major risk factor (5%), transient minor risk factor
(28%) and mostly idiopathic (61%). Indefinite treatment duration was
decided in 34 (23.4%) patients for the following reasons: thrombophilic
abnormalities (n=21), previous thrombosis (n=10), Behçet disease (n=1),
myeloproliferative disorder (1), immobilization (n=1). In patients who
stopped treatment, the mean duration of anticoagulation was 13.9±15.5
[1-96] months. The treatment duration was statistically more
prolonged in patients with pulmonary embolism or proximal deep veins
than distal localizations (29.9, 13.9 vs 8.1 moonths; p=0.02 and p=0.005
respectively). However, the durations of treatment in patients with
thrombosis of unusual site and in those with thrombosis of other
localizations were comparable (p=0.36). Curiously, duration of
anticoagulation was not significantly associated to neither a history of
thrombosis (22 vs 12 months; p=0.08) nor circumstances of thrombosis:
provoked by a transient factor (15.1 months), persistent factor (10.1
months) and idiopathic (13.4 months); p=0.6.
Inherited Thrombophilia screening: Laboratory investigations
were indicated in the following situations: age inferior to 50 years old
(57%), previous thrombosis (15%), family history of thrombosis (14%),
unusual localization (10.4%), idiopathic episode (3.1%). Among the 190
included patients, 131 were screened for the four parameters. The
prevalence of IT was 27.5% (n=36). As expected, the most frequent
abnormality was aPCR (27.5%). Deficiencies in AT, PC, and PS were found
in 2, 5 and 3 patients respectively. IT was not statistically associated
to the following factors: personal previous venous
thrombotic/cardiovascular events, family history of thrombosis, adverse
pregnancy outcome, idiopathic thrombosis.
Follow up: Among 190 included patients, 66 were lost to follow
up (Fig 1). For the other 124 patients, the mean duration of follow up
was 34±37.2 months since the Index VTE and 22.3 ±24.7 months since
anticoagulation withdrawal.