Clinical Prediction of Lower Limb Deep Vein Thrombosis in Symptomatic Hospitalized Patients

2001 ◽  
Vol 86 (10) ◽  
pp. 985-990 ◽  
Author(s):  
M. L. Nelzy ◽  
L. R. Salmi ◽  
S. Skopinski ◽  
J. C. Saby ◽  
P. Le Métayer ◽  
...  
Keyword(s):  
Lower Limb ◽  
Hospitalized Patients ◽  
Routine Practice ◽  
Clinical Prediction ◽  
Item Score ◽  
Vein Thrombosis ◽  
Wells Score ◽  
Deep Vein ◽  
Plaster Immobilization ◽  
Limb Deep Vein Thrombosis

SummaryWe evaluated two clinical scores for the prediction of deep venous thrombosis (DVT) in hospitalized patients (Wells’ and Kahn’s). We included 273 patients referred to the vascular exploration unit for the suspicion of DVT. A clinical questionnaire was filled in by the practitioner and the scores were calculated from this form. 66 of the 273 patients had a DVT. When Wells’ score was 3, a DVT was found by duplex echography in 51% patients ; when the score was 0, a DVT was found in 9%. Kahn’s score was not adapted to this population. We then developed a new simple score (cancer, palsy or plaster immobilization, warmth, superficial venous dilation, unilateral pitting edema, other diagnosis). A DVT was found in 76% patients with a score of 3 and in 11% in those with a score of 0. We therefore propose a 6-item score whose main advantages are simplicity and usefulness in routine practice.

Comparison of clinical prediction scores for the diagnosis of deep vein thrombosis in unselected population of outpatients and inpatients

2014 ◽  
Vol 30 (7) ◽  
pp. 469-474 ◽  
Author(s):  
N Sermsathanasawadi ◽  
P Suparatchatpun ◽  
T Pumpuang ◽  
K Hongku ◽  
K Chinsakchai ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Clinical Prediction ◽  
Probability Score ◽  
Vein Thrombosis ◽  
Wells Score ◽  
Unselected Population ◽  
Deep Vein ◽  
Compression Ultrasonography

Objectives The aim of this research was to compare the accuracy of the modified Wells, the Wells, the Kahn, the St. André, and the Constans score for the diagnosis of deep vein thrombosis of the lower limb in unselected population of outpatients and inpatients. Method The pretest of probability score was employed in consecutive 500 outpatients and inpatients with suspicion of deep vein thrombosis. All patients were examined with compression ultrasonography. Results Deep vein thrombosis was confirmed in 26.4%. In the unselected population of outpatients and inpatients, the accuracy of the modified Wells score and the Constans score was higher than other scores. Both scores were more accurate for the outpatients. There was no accurate score for the inpatient subgroup. Conclusions The modified Wells and the Constans score appear to be useful in the unselected population of outpatients and inpatients and particularly in the outpatient subgroup.

Performance of the Wells score in predicting deep vein thrombosis in medical and surgical hospitalized patients with or without thromboprophylaxis: The R-WITT study

2021 ◽  
pp. 1358863X2199467
Author(s):  
Jean-Eudes Trihan ◽  
Michael Adam ◽  
Sara Jidal ◽  
Isabelle Aichoun ◽  
Sarah Coudray ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Risk Stratification ◽  
Hospitalized Patients ◽  
Operating Characteristics ◽  
Vein Thrombosis ◽  
Ultrasound Study ◽  
Wells Score ◽  
Deep Vein ◽  
The Impact ◽  
Test Probability

The Wells score had shown weak performance to determine pre-test probability of deep vein thrombosis (DVT) for inpatients. So, we evaluated the impact of thromboprophylaxis on the utility of the Wells score for risk stratification of inpatients with suspected DVT. This bicentric cross-sectional study from February 1, 2018 to January 31, 2019 included consecutive medical and surgical inpatients who underwent lower limb ultrasound study for suspected DVT. Wells score clinical predictors were assessed by both ordering and vascular physicians within 24 h after clinical suspicion of DVT. Primary outcome was the Wells score’s accuracy for pre-test risk stratification of suspected DVT, accounting for anticoagulation (AC) treatment (thromboprophylaxis for ⩾ 72 hours or long-term anticoagulation). We compared prevalence of proximal DVT among the low, moderate and high pre-test probability groups. The discrimination accuracy was defined as area under the receiver operating characteristics (ROC) curve. Of the 415 included patients, 30 (7.2%) had proximal DVT. Prevalence of proximal DVT was lower than expected in all pre-test probability groups. The prevalence in low, moderate and high pre-test probability groups was 0.0%, 3.1% and 8.2% ( p = 0.22) and 1.7%, 4.2% and 25.8% ( p < 0.001) for inpatients with or without AC, respectively. Area under ROC curves for discriminatory accuracy of the Wells score, for risk of proximal DVT with or without AC, was 0.72 and 0.88, respectively. The Wells score performed poorly for discrimination of risk for proximal DVT in hospitalized patients with AC but performed reasonably well among patients without AC; and showed low inter-rater reliability between physicians. ClinicalTrials.gov Identifier: NCT03784937.

Abdominal aortic and iliac aneurysm presented as lower limb deep vein thrombosis: case report

2018 ◽  
Vol 120 (4) ◽  
pp. 271-273
Author(s):  
Vedran Pazur ◽  
Inga Dakovic Bacalja ◽  
Ivan Cvjetko ◽  
Ana Borovecki
Keyword(s):  
Deep Vein Thrombosis ◽  
Case Report ◽  
Lower Limb ◽  
Iliac Aneurysm ◽  
Vein Thrombosis ◽  
Abdominal Aortic ◽  
Deep Vein ◽  
Limb Deep Vein Thrombosis

Multiple systemic paradoxical embolisation of a lower limb deep vein thrombosis due to interatrial septal puncture: a rare complication of left atrial appendage occlusion

2021 ◽  
Vol 14 (8) ◽  
pp. e244061
Author(s):  
Kevin Patrick Millar ◽  
Rory Gallen ◽  
Ihsan Ullah ◽  
Samer Arnous
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Middle Cerebral Artery ◽  
Vein Thrombosis ◽  
Left Atrial Appendage Occlusion ◽  
Deep Vein ◽  
Limb Deep Vein Thrombosis

A 75-year-old woman with a history of intracranial haemorrhage, atrial fibrillation and coronary artery bypass graft underwent elective left atrial appendage occlusion (LAAO) for stroke prevention. The procedure was successful, however on the third postoperative day, she presented with a lymph leak at the right femoral venous access site. She was admitted for conservative management of the lymph leak with immobility and intravenous fluids. Her inpatient stay was complicated by a right lower limb deep vein thrombosis (DVT), left middle cerebral artery territory ischaemic stroke, pulmonary emboli (PEs) and a splenic infarction. The mechanism of the systemic emboli was that of paradoxical emboli from the DVT passing through an interatrial septal defect created as part of the LAAO procedure, a previously unreported complication of LAAO. She was managed with 6 months of low-dose oral anticoagulation for treatment of DVT and PE and has made a full neurological recovery.

DETECTION OF ACUTE LOWER LIMB DEEP VEIN THROMBOSIS (DVT) USING Tc-99m DMP-444 SCINTIGRAPHY.

1999 ◽  
Vol 24 (6) ◽  
pp. 470
Author(s):  
S. M. Salisbury ◽  
J. E. Seabold ◽  
S. L. Edell ◽  
J. A. Ponto ◽  
J. S. Murguia ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Limb Deep Vein Thrombosis
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