Incidence of venous thromboembolism in psychiatric inpatients: a chart review

Masahiro Takeshima,1,* Hiroyasu Ishikawa,1,2,* Kazumi Shimizu,3 Takashi Kanbayashi,1 Tetsuo Shimizu1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Department of Neuropsychiatry, Nakadori Rehabilitation Hospital, Akita, Japan; 3Palliative Care Center, A...

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Autores principales:	Takeshima M, Ishikawa H, Shimizu K, Kanbayashi T, Shimizu T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Computed tomography deep vein thrombosis D-dimer psychiatric patients venous thromboembolism pulmonary embolism Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/21a2a3fbfbba4c9986f41ee7f64a81b7
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spelling	oai:doaj.org-article:21a2a3fbfbba4c9986f41ee7f64a81b72021-12-02T05:26:56ZIncidence of venous thromboembolism in psychiatric inpatients: a chart review1178-2021https://doaj.org/article/21a2a3fbfbba4c9986f41ee7f64a81b72018-05-01T00:00:00Zhttps://www.dovepress.com/incidence-of-venous-thromboembolism-in-psychiatric-inpatients-a-chart--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Masahiro Takeshima,1,* Hiroyasu Ishikawa,1,2,* Kazumi Shimizu,3 Takashi Kanbayashi,1 Tetsuo Shimizu1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Department of Neuropsychiatry, Nakadori Rehabilitation Hospital, Akita, Japan; 3Palliative Care Center, Akita University Hospital, Akita, Japan *These authors contributed equally to this work Purpose: Venous thromboembolism (VTE) is the combination of pulmonary embolism (PE) and deep vein thrombosis. In recent years, VTE has been gaining attention in the field of psychiatry as it can cause sudden deaths in patients hospitalized in psychiatric departments. The purpose of this study was to investigate the incidence of VTE in psychiatric inpatients using contrast-enhanced computed tomography (CT). Patients and methods: At the psychiatric department of the Akita University Hospital, NANOPIA® D-dimer was measured in patients with suspected symptomatic VTE or believed to be at risk for asymptomatic VTE. A follow-up contrast-enhanced CT was also performed in cases of D-dimer values over 1 µg/mL. Patients diagnosed with VTE based on contrast-enhanced CT during hospitalizations between May 1, 2009 and April 30, 2017 were analyzed. VTE incidence was compared in restrained and unrestrained catatonic and noncatatonic patients. We also investigated whether VTE was symptomatic or asymptomatic as well as its outcomes. Results: The overall incidence of VTE was 2.3% (39/1,681) in the 8-year period. VTE was observed in 61.1% (11/18) of catatonic patients, 4.1% (11/270) of noncatatonic restrained patients, and 1.2% (17/1,393) of noncatatonic unrestrained patients. PE was observed in 76.9% (30/39) of VTE patients and 97.4% (38/39) of VTE patients were asymptomatic. Recovery was achieved in all cases of VTE treated with anticoagulation therapy. Conclusion: These results indicate that the risk of VTE is high in psychiatric inpatients and that PE is common in these population. The data may also suggest that contrast-enhanced CT is important in surveying thrombus in suspected cases of VTE. In the psychiatric field, proper attention must be given to VTE, regardless of the presence or absence of catatonia or restraint, particularly given that PE was observed in more than 75% of cases of VTE. Keywords: computed tomography, deep vein thrombosis, D-dimer, psychiatric patients, catatonia, pulmonary embolismTakeshima MIshikawa HShimizu KKanbayashi TShimizu TDove Medical PressarticleComputed tomographydeep vein thrombosisD-dimerpsychiatric patientsvenous thromboembolismpulmonary embolismNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 1363-1370 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computed tomography deep vein thrombosis D-dimer psychiatric patients venous thromboembolism pulmonary embolism Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Computed tomography deep vein thrombosis D-dimer psychiatric patients venous thromboembolism pulmonary embolism Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Takeshima M Ishikawa H Shimizu K Kanbayashi T Shimizu T Incidence of venous thromboembolism in psychiatric inpatients: a chart review
description	Masahiro Takeshima,1,* Hiroyasu Ishikawa,1,2,* Kazumi Shimizu,3 Takashi Kanbayashi,1 Tetsuo Shimizu1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Department of Neuropsychiatry, Nakadori Rehabilitation Hospital, Akita, Japan; 3Palliative Care Center, Akita University Hospital, Akita, Japan *These authors contributed equally to this work Purpose: Venous thromboembolism (VTE) is the combination of pulmonary embolism (PE) and deep vein thrombosis. In recent years, VTE has been gaining attention in the field of psychiatry as it can cause sudden deaths in patients hospitalized in psychiatric departments. The purpose of this study was to investigate the incidence of VTE in psychiatric inpatients using contrast-enhanced computed tomography (CT). Patients and methods: At the psychiatric department of the Akita University Hospital, NANOPIA® D-dimer was measured in patients with suspected symptomatic VTE or believed to be at risk for asymptomatic VTE. A follow-up contrast-enhanced CT was also performed in cases of D-dimer values over 1 µg/mL. Patients diagnosed with VTE based on contrast-enhanced CT during hospitalizations between May 1, 2009 and April 30, 2017 were analyzed. VTE incidence was compared in restrained and unrestrained catatonic and noncatatonic patients. We also investigated whether VTE was symptomatic or asymptomatic as well as its outcomes. Results: The overall incidence of VTE was 2.3% (39/1,681) in the 8-year period. VTE was observed in 61.1% (11/18) of catatonic patients, 4.1% (11/270) of noncatatonic restrained patients, and 1.2% (17/1,393) of noncatatonic unrestrained patients. PE was observed in 76.9% (30/39) of VTE patients and 97.4% (38/39) of VTE patients were asymptomatic. Recovery was achieved in all cases of VTE treated with anticoagulation therapy. Conclusion: These results indicate that the risk of VTE is high in psychiatric inpatients and that PE is common in these population. The data may also suggest that contrast-enhanced CT is important in surveying thrombus in suspected cases of VTE. In the psychiatric field, proper attention must be given to VTE, regardless of the presence or absence of catatonia or restraint, particularly given that PE was observed in more than 75% of cases of VTE. Keywords: computed tomography, deep vein thrombosis, D-dimer, psychiatric patients, catatonia, pulmonary embolism
format	article
author	Takeshima M Ishikawa H Shimizu K Kanbayashi T Shimizu T
author_facet	Takeshima M Ishikawa H Shimizu K Kanbayashi T Shimizu T
author_sort	Takeshima M
title	Incidence of venous thromboembolism in psychiatric inpatients: a chart review
title_short	Incidence of venous thromboembolism in psychiatric inpatients: a chart review
title_full	Incidence of venous thromboembolism in psychiatric inpatients: a chart review
title_fullStr	Incidence of venous thromboembolism in psychiatric inpatients: a chart review
title_full_unstemmed	Incidence of venous thromboembolism in psychiatric inpatients: a chart review
title_sort	incidence of venous thromboembolism in psychiatric inpatients: a chart review
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/21a2a3fbfbba4c9986f41ee7f64a81b7
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Incidence of venous thromboembolism in psychiatric inpatients: a chart review

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