Profile of deep-vein thrombosis patients in service hospital with specific reference to high-altitude thrombosis

Background: Deep vein thrombosis (DVT) often goes unrecognized and can cause severe morbidity and even mortality. Exposure to high altitude, immobilization, trauma and surgery are commonly recognised risk factors. Thrombophilia is also one of the important risk factors for recurrent thromboembolic events in younger population. Material and Methods: A prospective case series conducted at a zonal service hospital, in the chain of rearward evacuation from high altitude area in north India, among all the patients diagnosed with DVT (N=144) during the study period from Jan 2014 to Dec 2016. After history and clinical examination, the patients proven to have DVT with Colour Doppler Flow Imaging (CDFI) were included in the study. All the patients were treated with low molecular weight heparin (LMWH) initially and overlapped with oral anti-coagulants (OAC). Results: DVT accounted 0.41 % of total hospital admissions. Exposure to high altitude was recognised as the commonest predisposing factor in 25.7% cases. Immobilization, trauma, and surgery were the other common causes identified. Lower extremities, especially left lower limb was found to be most commonly affected in 57.6% cases. Involvement of multiple anatomical venous segments was commonly observed. The incidence of pulmonary embolism was 0.69%. LMWH followed by OAC proved to be an effective treatment modality with 81.2% patients showing improvement,4.9% remaining static and only 13.9% showing worsening.Conclusion: Acute DVT is responsible for the substantial burden of venous thrombo embolism (VTE) in healthy personnel posted to high altitude (HA). Exposure to high altitude, immobilization, trauma and surgery are common predisposing factors of DVT.