Does carbapenem-resistant enterobacteriaceae infection drive venous thromboembolism in patients admitted to intensive care units receiving prophylactic anticoagulants?

Abstract

BACKGROUND: Systemic infections are one of several risk factors leading to the development of inflammation and venous thromboembolism (VTE) formation. This study aimed to assess the risk factors associated with the development of VTE in patients admitted to the intensive care unit (ICU). MATERIALS AND METHODS: A retrospective-matched case − control study of patients with VTE in the period between January 1, 2018, and December 31, 2019. We included all adult patients who stayed more than 2 days in ICU before the development of VTE. RESULTS: Univariate and multivariate analyses uncovered three of six factors to have significant influence in the development of VTE in ICU patients: Carbapenem-resistant Enterobactereaceae (CRE) infections (odds ratio [OR] 2.95, 95% confidence interval (CI) 1.21–7.33, P = 0.010), length of ICU stay (OR 1.02, 95% CI 1.01–1.04, P = 0.011), and the sequential organ failure assessment score (OR 1.10, 95% CI 1.01–1.20, P = 0.031); all were found to be independent risk factors in the development of VTE. CONCLUSION: Our findings suggest that, CRE infection is a strong trigger to the development of VTE in patients admitted to the ICU, and draw the attention of the treating clinicians to prioritize these infections in the management protocols to control infection-driven VTE in ICU patients.

Keywords

• carbapenem-resistant enterobactereaceae
• infection
• intensive care
• prophylactic anticoagulants
• venous thromboembolism