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Publications

Journal Article Epublish

PubMed: 41509938 DOI: 10.55730/1300-0144.6111

Etiology and outcomes of upper extremity venous thrombosis: a retrospective cohort study.

Turk J Med Sci 55(6):1526-1539

Authors: Selçuk Coşkun, Ferhat Içme, Pınar Köksal Coşkun, Mehmet Ali Ceyhan

Affiliations

  • Department of Emergency Medicine, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkiye.
  • Department of Cardiovascular Surgery, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkiye.

Abstract

BACKGROUND/AIM

Upper extremity venous thrombosis (UEVT), encompassing upper extremity deep vein thrombosis (UEDVT) and superficial vein thrombosis (UESVT), is increasingly recognized due to invasive procedures and advanced diagnostics. This study characterizes the 5-year outcomes and etiological factors of UEVT in a large cohort.

MATERIALS AND METHODS

We conducted a retrospective cohort study of 304 consecutive adult patients with acute UEVT (2019-2025) at a tertiary care center in Türkiye. Demographics, medical history, thrombosis characteristics, treatments, and outcomes-including thrombosis resolution, pulmonary embolism, and mortality-were analyzed. Statistical analyses were performed using chi-square tests, multivariate logistic regression, and random forest models.

RESULTS

Among the 304 patients, 4 (1.32%) had primary UEDVT, 115 (37.8%) had secondary UEDVT, 112 (36.8%) had nonfistula UESVT, and 73 (24.0%) had fistula-related UESVT. UEDVT was associated with malignancy (38.3%, n = 44), central venous catheters (25.2%, n = 29), rheumatologic disorders (n = 15), and coagulopathies (n = 10). Nonfistula UESVT was linked to local factors (e.g., IV contrast, n = 14; IV drug use, n = 12), with no pulmonary embolism (PE) or mortality. Fistula-related UESVT had a 1.4% PE and mortality rate. UEDVT showed higher PE (29.6% vs. 1.1%, p < 0.001) and mortality (23.5% vs. 0.5%, p < 0.001) than UESVT. Multivariate analysis identified UEDVT (OR = 36.50, 95% CI: 8.58%-155.31%), cancer (OR = 2.80), and heart failure (OR = 3.15) as PE predictors, while UEDVT (OR = 58.76), cancer (OR = 9.50), and age (OR = 1.05) were predictors of mortality (all p < 0.05).

CONCLUSIONS

UEDVT, driven by systemic factors, carries a higher risk of PE and mortality than UESVT, influenced by local factors. Thorough etiological evaluation and tailored interventions (e.g., catheter removal, multidisciplinary management) are critical to mitigate complications.

MeSH

Rheumatology, Mortality, Fistula, Embolism, Hematology, Venous Thrombosis, Neoplasms, Cohort Studies, Thrombophlebitis, Pulmonary Embolism, Thrombosis, Veins, Catheters