Abstract
Patients are frequently referred to hospital for exclusion of deep vein thrombosis (DVT); however, the diagnosis is only confirmed in 12% of those undergoing investigation. An effective strategy is required, which minimises the number of negative investigations, while safely excluding or confirming the diagnosis. This study investigates the combination of clinical risk scoring and strain-gauge plethysmography in the initial assessment of patients with suspected DVT. A survey was conducted of 1300 patients referred with suspected DVT over the course of a year. The results of this investigation were comparable to previous clinical trials and supports the use of strain-gauge plethysmography combined with clinical risk score in a busy acute medical unit.
[download-attachments container="div" style="list" dipslay_icon="1" display_count="1" display__size="0"]
References
- Nordstrom M, Lindblad B, Bergqvist D, et al. A prospective study of the incidence of deep-vein thrombosis within a defined urban population. J Intern Med 1992; 232:155-160.
- Oger E. Incidence of venous thromboembolism: a community-based study in Western France. EPI-GETBP Study Group. Groupe d’Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost 2000; 83: 657- 660.
- Wells PS, Anderson DR, Rodger M, et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003 Sep 25; 349: 1227-35
- Huisman MV, Büller HR, ten Cate JW, et al. Management of clinically suspected acute venous thrombosis in outpatients with serial impedance plethysmography in a community hospital setting Arch Intern Med. 1989; 149: 511-3.
- H Heijboer, HR Buller, A Lensing et al. A comparision of real-time compression ultrasonography with impedence plethysmography for the diagnosis of deep-vein thrombosis in symptomatic out-patients. N Engl J Med 1993; 329: 1365-1369
- S Goodacre et al. Measurement of the clinical and cost-effectiveness of non-invasive diagnostic testing strategies for deep vein thrombosis. Health Technol Assess 2006; 10:
- Singh MK, Tonks KG, Langford NJ, et al. Deep vein thrombosis assessment clinic: evaluation of a new working practice. Acute Medicine 2005: 4; 64-67
- Wells PS, Hirsh J, Anderson DR, Lensing AW, et al. A simple clinical model for the diagnosis of deep-vein thrombosis combined with impedance plethysmography: potential for an improvement in the diagnostic process. J Intern Med 1998; 243: 15–23.
- Patterson RB, Fowl RJ, Keller JD, et al. The limitations of impedance plethysmography in the diagnosis of acute deep venous thrombosis. J Vasc Surg 1989; 9: 725–9
- EM Roumen-Klappe, M den Heijer, MCH. Janssen, et al. The postthrombotic syndrome: incidence and prognostic value of non-invasive venous examinations in a six-year follow-up study. Thromb Haemost 2005; 94: 825-830
