# Clinical Profile of Patients Admitted With Venous Thrombosis to a Tertiary Care Hospital in India

## TL;DR

This study describes the clinical profile of Indian patients with venous thrombosis, highlighting the prevalence of deep vein thrombosis and the effectiveness of the modified Wells criteria in classifying cases.

## Contribution

The study provides new clinical data on venous thrombosis in a hilly region of India and evaluates the modified Wells criteria's applicability in this population.

## Key findings

- Deep vein thrombosis was the most common type of venous thrombosis observed in the study.
- The modified Wells criteria classified most confirmed DVT and PTE cases as 'likely' when applied retrospectively.
- Elevated D-dimer levels were prevalent across various venous thrombosis sites, with the highest in cerebral venous thrombosis.

## Abstract

Background and objectives: Venous thrombosis is a frequent cause of hospitalization worldwide; however, data describing its clinical profile in Indian patients, particularly from hilly regions, remain limited. The present study aimed to describe the clinical profile of patients admitted with venous thrombosis to the medical wards of a tertiary care hospital in Himachal Pradesh, India. Additionally, we examined the prevalence of elevated D-dimer levels across different venous thrombosis sites and assessed the proportion of patients with confirmed deep vein thrombosis (DVT) and pulmonary embolism who would have been retrospectively classified as “likely” using the modified Wells criteria.

Methods: This cross-sectional observational study was conducted over a one-year period. All adult patients admitted with clinically suspected and radiologically confirmed venous thrombosis who met the inclusion and exclusion criteria were included. Clinical characteristics were described, and the prevalence of elevated D-dimer levels across different venous thrombosis sites was assessed. The modified Wells pre-test probability scores were applied retrospectively to patients with confirmed DVT and pulmonary embolism to determine the proportion classified as “likely.”

Results: A total of 76 patients admitted with venous thrombosis were enrolled in the study. The mean age of the patients was 47.4 ± 16.3 years, and the female to male ratio was 1.3:1. Most patients had DVT (64.5%) (n=49) followed by pulmonary thromboembolism (PTE) (15.8%) (n=12) and cerebral venous thrombosis (CVT) (11.8%) (n=9) either as an isolated event or in combination with other venous thrombosis. Out of 49 DVT patients, the left lower limb was most commonly affected (75%) (n=36), and the most common presentation was limb swelling (95.9%) (n=47). The most common vessel involved was the femoropopliteal vein (38.8%) (n=19). Elevated D-dimer levels were observed in 91.8% (95% CI, 80.4-97.73%), 88.9% (95% CI, 51.75-99.72%), 100% (95% CI, 73.54-100%), and 81.82% (95% CI, 48.22-97.72%) of patients with DVT, CVT, PTE, and other thrombosis sites, respectively. When the modified Wells scores were applied retrospectively, 46 of 49 patients with DVT (93.9%; 95% CI: 83.13-98.72%) were classified as “Likely DVT” (score ≥2), while three patients (6.1%) were classified as “Unlikely DVT”. Among the 12 patients with PTE, 11 patients (91.7%; 95% CI: 61.52-99.79%) were classified as “Likely PTE” according to the modified Wells criteria.

Conclusion: Venous thrombosis was a common cause of admission, with isolated DVT being the most frequent presentation, followed by PTE and CVT. Smoking and malignancy were commonly observed in this cohort, reflecting their prevalence rather than independent risk associations. Most patients with confirmed DVT and PTE would have been retrospectively classified as “likely” by the modified Wells criteria; however, this represents case-based classification and not validation of the model. Further prospective studies are needed to evaluate diagnostic tools and risk factors.