Asymptomatic deep vein thrombosis in patients undergoing screening duplex ultrasonography

Journal of Hospital Medicine - Tập 9 Số 1 - Trang 19-22 - 2014
Marc T. Zubrow1, Jessica Urie2, Claudine Jurkovitz3, Xiaozhang Jiang4, J. Richard Bowen3, Angela DiSabatino5, William S. Weintraub5
1Department of Medicine, University of Maryland Medical System, Baltimore, Maryland.
2Chester County Hospital Department of Nursing West Chester Pennsylvania
3Value Institute, Christiana Care Health System, Newark, Delaware
4Center for Outcomes Research, Christiana Care Health System
5Center for Cardiac and Vascular Health, Christiana Care Health System

Tóm tắt

BACKGROUNDBecause of concerns for propagating clots into pulmonary emboli by the placement of pneumatic compression boots (PCBs), the standard of care at our institution was to perform a duplex Doppler ultrasound with compression (DUSC) before applying PCBs. We sought to determine the rate of asymptomatic preexisting deep vein thrombosis (DVT) in hospitalized patients who underwent DUSC before PCB.METHODSWe evaluated consecutive patients who underwent lower extremity DUSC within 48 hours of admission. All patients were assessed for DVT risk factors using the American College of Chest Physicians' criteria (American College of Chest Physicians Conference on Antithrombotic/Thrombolytic Therapy: Evidence‐Based Guidelines, 9th Edition). A t test, Wilcoxon rank sum test, and χ2 or Fisher exact test were used to compare patients characteristics according to DVT status. Logistic regression was used to determine the importance of each risk factor on the risk of DVT.RESULTSDUSC was performed during 1136 hospitalizations; 1071 patients were included in the dataset. Of those, 19 patients (1.8%) had asymptomatic DVT and had at least 1 risk factor; 16 (84.2%) had more than 1 risk factor. The only risk factors that were statistically significant were ambulatory dysfunction and thromboembolic disease history.CONCLUSIONFew patients have asymptomatic DVT upon admission; all of these patients have at least 1 predisposing risk factor. There appears to be no need for DUSC prior to initiation of PCBs. DUSC evaluation for DVT may be of value if there is a history of previous DVT, ambulatory dysfunction, or more than 3 risk factors, as the information may change therapeutic approaches. Journal of Hospital Medicine 2014;9:19–22. © 2013 Society of Hospital Medicine

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Journal of Hospital Medicine

Tập 9 Số 1

19-22

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