Deep Vein Thrombosis After Earthquake: A Systematic Review and Meta-analysis

Abstract

Abstract Objective: Among natural disasters, earthquake is associated with heavy fatalities and financial damages, causing considerable mortality. The complications resulting from getting trapped in rubble, secondary traumas, obligation to reside in temporary shelters, along with other factors such as limited mobility, stress, and dehydration, predispose earthquake survivors to Deep Vein Thrombosis (DVT). The aim of the present study is to investigate the rate of DVT after an earthquake using a systematic review and meta-analysis. Methods: To perform the present study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used. The protocol of this review study has been registered in the International Perspective Register of Systematic Review (PROSPERO) with the code of CRD42021290375. Credible data resources including PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Magiran, SID, and Embase were used for extracting relevant studies. Random effect model was used to perform the meta-analysis. I2 was ritualized to investigate heterogeneity across the studies. Publication bias of studies was evaluated using the Begg test. Results: In this study, 267 primary studies were identified and extracted. After removing the duplicate ones and the screening, eventually 12 final studies were chosen for the meta-analysis. Based on the meta-analysis results, the total rate of DVT was 9.07% (95% confidence interval [CI]: 7.32-10.81; I2 = 97.9%; P = 0<0.001). Analysis of DVT in the subgroups of the general population and patient survivors were 11.43% (95% CI: 9.06-13.79; I2 = 98%; P = 0<0.001) and 2.51% (95% CI: 0.04-4.63; I2 = 77.7%; P = 0.001). Also, based on the Begg test, the publication bias in the chosen studies was not considerable. Conclusions: DVT rate in earthquake survivors is higher compared with other disasters, and over time it finds a growing trend. After earthquake, the focus of rescue and health-care teams is on individuals with observable injuries and damages. Because DVT is first asymptomatic but has fatal consequences, including pulmonary embolism and sudden death, it should be incorporated in health’s status assessment of earthquake-stricken people as well as screening and diagnostic programs of health-care providers.