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Early positive fluid balance is predictive for venous thromboembolism in critically ill surgical patients
Ting-Lung Lin1, Navpreet K Dhillon2, Geena Conde2
1Department of Surgery, Division of Trauma and Critical Care Cedars-Sinai Medical Center, Los Angeles, CA, United States; Departments of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Background:
Positive fluid balance (FB) in the intensive care unit (ICU) may be a marker for increased venous thromboembolism (VTE) risk. We hypothesized that an early positive fluid balance (FB) would be associated with increased VTE occurrence.
Methods:
A single-center retrospective review of surgical ICU patients was conducted from May 2011 to December 2014. Patients with a VTE were compared to those who did not develop a VTE (NVTE).
Results:
There were 619 patients analyzed with 77 (12.4%) diagnosed with a VTE; these patients had longer ventilator days (12.3 vs. 5.0 days, p < 0.01) and ICU stays (10.3 vs. 6.4 days, p < 0.01), and were more likely to have a net FB ≥ 4L over the first three days (62% vs. 44%, p < 0.01). A FB ≥ 4L over the first three ICU days was an independent predictor of VTE (AOR 1.74, p = 0.04).
Conclusion:
Patients with an early positive FB are more likely to develop a VTE.
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