This audit was undertaken with the aim of determining

• VTE recurrence rates
• Haemorrhagic episodes
• Compliance with anticoagulation protocols

All patients with a first episode DVT during the year 2001 were identified from our Dawn AC database The case records were obtained and key demographic and clinical data were retrieved.

Of the 100 patients identified from the computer system, 82 patients were eligible and case notes available. There were 45 women and 37 men with a median age of 71 years, and average follow up of 21 months. Over 70% of DVT s were proximal and were more likely to affect the right leg. Only 23 of the 82 episodes were idiopathic. The most common triggering event was malignancy, followed by immobility, surgery oestrogen use, trauma and air travel.

The median duration of LMWH therapy following diagnosis was 6 days, with 17% of patients receiving less than 5 days. The median time to INR>2 was 4 days with only two patients taking longer than 6 days. The vast majority of patients took warfarin for 6 months or less.

There was one fatal intracranial bleed at 4 months, INR 1.7 at the time of the event. Three VTE recurrences were documented. The first occurred at 42 months, related to repeated IVDU use. The second occurred at 49 months shortly after bowel cancer was diagnosed. and the third within a few days of the initial event.

During the period of follow up 35 patients died, with the most common cause being malignancy, followed by infection.

In summary

• The majority of patients with first episode DVT are elderly
• The documented recurrence for this cohort is lower than in published studies
• The fatal bleeding rate at 0.7% pa is similar to other reports
• The major causes of death in patients with a history of DVT are malignancy and infection