Prevalence of acute deep vein thrombosis in HIV Seropositive Orthopaedic patients after major surgery at the University Teaching Hospital, Lusaka

Abstract

Hypercoagulable states and immobilization are known risk factors in the development of DVT after major orthopaedic surgery. However, the added effect of HIV to major orthopaedic surgery in developing DVT is unknown. In addition the benefits of D-dimer screening of patients after major surgery is not emphasized. A total of 42 Patients, 23 (54 %) were HIV negative (control) and 19 (46 %) were HIV positive were recruited by convenient sampling. Prior to surgery demographic and HIV status data was recorded. After surgery a blood sample was tested for D-dimer levels. The patients were then monitored acute DVT clinically and confirmed by ultrasound. The HIV positive cohort recorded 19 (46%) and the control (HIV negative) cohort recorded 23 (54%) participants. The results showed no significant difference in the development of acute DVT; (5.3%) in the HIV positive group and (4.3%) in the HIV negative group. In addition, no significant difference between the two groups in the number of positive D-Dimers, (97.7%) in the HIV positive cohort and (95.7%) in the HIV negative cohort group. In both cohorts, hip and knee surgeries had high values for D-Dimers. There was a positive correlation between D-dimers value and the site of surgery HIV positive cohort R = +0.390, p = 0.049 and control R = + 0.398 p = 0.03. The study shows no added effect of HIV in the known risk of major orthopaedic surgery in the development of DVT. Major orthopaedic surgery is a risk in developing DVT as shown in this study by high levels of D-dimers in both groups. Therefore the study recommends a blood test for D-dimers be incorporated in clinical risk assessment tool. Key Words: Deep Vein Thrombosis, HIV Sero-Positive, HIV Sero-Negative, D-Dimer, Doppler Ultra Sound