Venous thromboembolism in hospital emergency room. A retrospective study on climatic effect

Autor: Maria Fiore, Giuseppe Dattilo, Agostino Gaudio, Giovanni Lumera, Gea Oliveri Conti, Salvatore Santo Signorelli, Giuseppe Carpinteri, Margherita Ferrante
Rok vydání: 2020
Předmět:
Laboratory test
medicine.medical_specialty
Deep vein
Symptom
010501 environmental sciences
Hematocrit
01 natural sciences
Biochemistry
03 medical and health sciences
0302 clinical medicine
Risk Factors
Deep vein thrombosis
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Mean platelet volume
Sicily
0105 earth and related environmental sciences
General Environmental Science
Retrospective Studies
Venous Thrombosis
Pulmonary embolism
Deep vein thrombosis
Symptom
Laboratory test
Emergency room
Seasonal effects

medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Pulmonary embolism
Emergency room
Retrospective cohort study
Venous Thromboembolism
medicine.disease
Seasonal effects
Thrombosis
Lower limb pain
Hospitals
medicine.anatomical_structure
business
Emergency Service
Hospital
Zdroj: Environmental research. 197
ISSN: 1096-0953
Popis: Several cardiovascular conditions exhibit seasonality in frequency and mortality, but little is known about the seasonality of Venous ThromboEmbolism (VTE), a very relevant medical condition, and seasonal influences are still conflicting. Patients having co-morbidities, individual suffered from dyspnea, swelling, edema of lower limb, pain (chest, lower limbs) are admitted frequently to the hospital emergency room (HER), particularly. Both mark a potential risk for VTE, that can be increased also by seasonality. A four years retrospective analysis (2016–2019) was carried out in individuals and patients admitted to the HER of the Hospital of Catania (a Mediterranean city of Sicily, Italy) to evaluate the VTE frequency and its seasonal differences, common symptoms, potential usage of some common laboratory tests. Dyspnea, swelling, edema of lower limb and pain (chest, lower limbs) were considered to suspect pulmonary embolism (PE) or for deep vein thrombosis of lower limb (DVT). Platelet count, platelet volume, fibrinogen, C-reactive protein, and D-dimer were considered. VTE frequency per year was 2.9/10,000 (2016), 4.9/10,000 (2017) 3.6/10,000 (2018), and 5.1/10,000 (2019) respectively. Dyspnea was highly frequent for PE, edema and lower limb pain were frequent in DVT patients. Fibrinogen, C reactive protein, and D-dimer values were found raised in all the VTE patients. Platelet volume was found higher in DVT than PE VTE events that occurred in warm periods were modestly greater (57 VTE: 38 DVT, 19 PE) compared to cold months (52 VTE: 34 DVT, 18 PE). Our results could be explained by the increased sweating due to the high temperatures, which in turn, can affect both on plasma concentration and on hematocrit value coupled to the reduction in atmospheric pressure determining both a hyper-coagulative condition. Climate seasonal characteristics, and environmental conditions in Catania city (Sicily) may be as reasonable items in expecting on different VTE rates in warm period compared to cold. This study highlights no specific symptoms, and confirms the common lab tests for individuals and patients admitted to HER as simple and helpful tools in initiating none or mini-invasive diagnostic strategy for the VTE. Finally, the climate/seasonality coupled with latitude can have a direct influence on the incidence of DVT.
Databáze: OpenAIRE