Hospitalized Recurrent Deep Vein Thrombosis: Demographic, Clinical, and Laboratory Insights from a Single-Center Retrospective Study

Yıl 2025, Cilt: 15 Sayı: 2, 229 - 236, 31.08.2025

Mustafa Oguz Cumaoglu , Turgut Dolanbay , Abdussamed Vural , Ömer Yüceer , Alpay Tuncar , Seyyid Rasim Yanmaz

Öz

Aim: This study aimed to analyze the demographic, clinical, and laboratory characteristics of hospitalized patients with recurrent deep vein thrombosis (rDVT) and to identify associated risk factors and treatment outcomes.
Material and Methods: A retrospective review was conducted on 45 patients hospitalized with rDVT between October 2021 and October 2023. Patients with active cancer, hematological or rheumatological diseases, immunosuppression, or organ failure were excluded. Demographic data, clinical characteristics, venous Doppler imaging, and emergency laboratory results were analyzed. Patients were grouped based on proximal or distal thrombus location, infection burden, and hospital length of stay. Statistical analyses included Student’s t-test, Mann-Whitney U test, and Spearman correlation.
Results: The median age of the study population was 72 years, with a higher prevalence in males (55.6%). Key risk factors included major surgery within two years (40%), diabetes mellitus (37.8%), and hormone replacement therapy (22.2%). Proximal thrombus was identified in 51% of patients, with males predominantly affected, while females showed higher rates of distal thrombus. Median hospital stay was five days, and longer stays were associated with elevated inflammatory markers, including CRP and uric acid levels. A significant correlation between D-dimer and uric acid was observed (r=0.40, p=0.005). Dual therapy with low molecular weight heparin and rivaroxaban was more common in proximal thrombus cases.
Conclusion: This study highlights the distinct clinical and laboratory characteristics of hospitalized rDVT patients, with gender– and location-specific differences influencing management strategies. The positive correlation between D-dimer and uric acid suggests a potential role of uric acid as a biomarker in resource-limited settings. Further research is warranted to address the genetic and hereditary aspects of rDVT.

Anahtar Kelimeler

recurrent deep vein thrombosis , risk factors , thrombus location , anticoagulation therapy; laboratory biomarkers

Kaynakça

• 1. Moyer E, Bernard K, Gottlieb M. Epidemiology of Deep Venous T hrombosis Among United States Emergency Departments Over an Eight-Year Period. Clin Exp Emerg Med. Published online October 16, 2024.
• 2. Falster C, Mørkenborg MD, Thrane M, Clausen J, Arvig M, Brockhattingen K, et al. Utility of ultrasound in the diagnostic work-up of suspected pulmonary embolism: an open-label multicentre randomized controlled trial (the PRIME study) . Lancet Reg Health Eur. 2024;42:100941.
• 3. Lago-Rodríguez MO, López-Rubio M, Moragón-Ledesma S, Oblitas CM, Galeano-Valle F, Atienza F, et al. Incidence and longterm outcomes of upper limb deep vein thrombosis associated with intracardiac devices: analysis of bleeding, recurrence, and sequelae. Intern Emerg Med. 2024;19(7):1959–66.
• 4. Tritschler T, Kraaijpoel N, Le Gal G, Wells PS. Venous thromboembolism: advances in diagnosis and treatment. JAMA. 2018;320:1583–94.
• 5. Ribeiro DD, Lijfering WM, Barreto SM, Rosendaal FR, Rezende SM. Epidemiology of recurrent venous thrombosis. Braz J Med Biol Res. 2012;45:1–7.
• 6. Silva CXE, Ribeiro DD, Lijfering WM, Azevedo PDGG, Brommonschenkel CC, Torres MS, et al. Risk of recurrent venous thromboembolism related to prior risk situations: reevaluation of a cohort study with a longer follow-up. Blood Coagul Fibrinolysis. 2020;31(7):434–39.
• 7. Kearon C, Parpia S, Spencer FA, Schulman S, Stevens SM, Shah V, et al. Long-term risk of recurrence in patients with a f irst unprovoked venous thromboembolism managed according to d-dimer results;A cohort study. J Thromb Haemost. 2019;17(7):1144–52.
• 8. Dronkers C, Klok F, Langevelde K, Šrámek A, Haren G, Huisman M, et al. Diagnosing recurrent dvt of the leg by two different non-contrast-enhanced magnetic resonance direct thrombus imaging techniques: a pilot study. TH Open. 2019;03(01):e37–44.
• 9. Timp JF, Braekkan SK, Lijfering WM, Vlieg AH, Hansen JB, Rosendaal FR, et al. Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden T hrombosis Recurrence Risk Prediction model (L-TRRiP). PLoS Med. 2021;18(4):e1003612.
• 10. Labropoulos N, Jen J, Jen H, Gasparis AP, Tassiopoulos AK. Recurrent deep vein thrombosis. Annals of Surgery. 2010;251(4):749–53.
• 11. Eischer L, Eichinger S, Kyrle PA. Age at first venous thromboembolism and risk of recurrence: a prospective cohort study. Medicine. 2009;88:366–70.
• 12. Bjøri E, Johnsen HS, Hansen JB, Brækkan SK. D‐dimer at venous thrombosis diagnosis is associated with risk of recurrence. Journal of Thrombosis and Haemostasis. 2017;15(5):917–24.
• 13. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149(2):315–52.
• 14. Stubbs MJ, Mouyis M, Thomas M. Deep vein thrombosis. Br Med J. 2018;360:k351.
• 15. Venous thromboembolism. National Heart, Lung, and Blood Institute. https://www. nhlbi. nih. gov/health/venousthromboembolism;2024 [Accessed 10. 07. 24].
• 16. Al Yami MS, Alshehri AM, Alotaibi GM, Alsulimani MS, Alotaibi FB, Alotaibi RA, et al. Clinical Characteristics and Outcomes of Deep Vein Thrombosis in Relation to Location: A Retrospective Analysis Study. Clin Appl Thromb Hemost. 2025;31.
• 17. Hansson P, Sörbo J, Eriksson H. Recurrent venous thromboembolism after deep vein thrombosis. Arch Intern Med. 2000;160(6):769.
• 18. Linnemann B, Blank W, Doenst T, Erbel C, Isfort P, Janssens U, et al. Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism. The revised AWMF S2k Guideline. Vasa. 2023;52(S111):1–146.
• 19. Cieślik J, Mrozińska S, Broniatowska E, Undas A. Altered plasma clot properties increase the risk of recurrent deep vein thrombosis: a cohort study. Blood. 2018;131(7):797–807.
• 20. Van Dam LF, Gautam G, Dronkers CEA, Ghanima W, Gleditsch J, Von Heijne A, et al. Safety of using the combination of the Wells rule and D-dimer test for excluding acute recurrent ipsilateral deep vein thrombosis. J Thromb Haemost. 2020;18(9):2341–48.
• 21. Wu Y, Chu C, Song P, Yang Y, Lin C, Xu Q. Plasma D-dimer is a Promising Indicator for the Treatment of Acute Gouty Attack. Ann Clin Lab Sci. 2018;48(4):435–39.
• 22. Ates B, Sazak S, Turkmenoglu Y, Irdem A, Dursun H. Relationship of serum vitamin D, D-dimer and uric acid levels with attacks in children with familial Mediterranean fever. The Egyptian Rheumatologist. 2022;44(4):301–05.
• 23. Wei L, Laukkanen JA, Li Y, Chen X, Li G. Association of High apoB/apoA1 Ratio with Increased Erythrocytes, Platelet/Lymphocyte Ratio, D-dimer, Uric Acid and Cardiac Remodeling in Elderly Heart Failure Patients: A Retrospective Study. Int J Gen Med. 2024;17:2151–61.
• 24. Ren W, Huang Q, Fan K, Hu J, Cheng Q, Xu M, et al. Uric acid played a role in the association between gender and deep vein thrombosis in patients with stroke. Nutr Metab Cardiovasc Dis. 2021;31(9):2700–06.
• 25. Shimodaira M, Niwa T, Nakajima K, Kobayashi M, Hanyu N, Nakayama T. Gender differences in the relationship between serum uric acid and mean platelet volume in a Japanese general population. Platelets. 2014;25(3):202–06.
• 26. Karagoz Y, Sahin I, Karagoz F, Sit D. Evaluation of relationship between uric acid and crp, rdw, and mpv as cardiovascular risk factors in patients with hypertension. Bezmialem Science. 2016;5(1):16–21.
• 27. Grigorean A, Lindenblatt N, Luchsinger I, Hobohm L, Konstantinides SV, Münzel T, et al. Prevalence and Prognostic Role of Lymphedema in Patients with Deep Venous Thrombosis and Thrombophlebitis. Lymphat Res Biol. 2024;22(1):20–6.
• 28. Colling ME, Tourdot BE, Kanthi Y. Inflammation, Infection and Venous Thromboembolism. CircRes. 2021;128(12):2017–36.