The Risk of Deep Venous Thrombosis in Surgical Patients Using Multivariate Analysis

Mapping Intimacies ◽

10.1055/s-0039-1689617 ◽

1975 ◽

Author(s):

A. N. Nicolaides ◽

Doreen Irving

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Varicose Veins ◽

Maximum Likelihood Estimates ◽

Clinical Factors ◽

Logistic Analysis ◽

History Of ◽

Fibrinogen Test ◽

A Prospective Study ◽

Significant Factors

The purpose of the present study was to develop a method of determining the patients who are at risk and require prophylaxis.In a prospective study of 535 patients various clinical factors believed to predispose to deep venous thrombosis have been studied using a linear logistic analysis. The patients had been screened with the 125I-fibrinogen test. A standard computer program was used to obtain the maximum likelihood estimates of the coefficients for the various factors studied. The most important factor was age; premedication with omnopon, presence of varicose veins, infection, history of previous DVT, severity and type of operation were also significant.For any patient the logit y can be estimated and expressed as a percentage risk of thrombosis using the equation y = −6.00 + (Age × 0.0617) + (History of previous DVT × 1.38) + (V. veins × 1.26) + (Premedication with omnopon × 0.97) + (Infection × 0.84) -(Urological operation × 1.94) - (Thoracic operation × 1.15) derived from the significant factors and their coefficients. (The values of factors other than age are either 0 = absent, or 1 = present.)

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Diagnosis of Recurrent Deep Venous Thrombosis Using B-Mode Ultrasonic Imaging

Phlebology The Journal of Venous Disease ◽

10.1177/026835558600100304 ◽

1986 ◽

Vol 1 (3) ◽

pp. 181-188 ◽

Cited By ~ 5

Author(s):

David L. Rollins ◽

Carolyn Semrow ◽

Keith Calligaro ◽

Mark Friedell ◽

Dale Buchbinder

Keyword(s):

Prospective Study ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Ultrasonic Imaging ◽

Accurate Diagnosis ◽

Recurrent Thrombosis ◽

Postphlebitic Syndrome ◽

History Of ◽

A Prospective Study ◽

Calf Vein

Accurate diagnosis of recurrent deep venous thrombosis (DVT) in patients with postphlebitic syndrome or a history of previous DVT can be extremely difficult. Real-time B-mode ultrasonic imaging (UI) was compared to ascending contrast venography (ACV) in a prospective study of 38 limbs with suspected recurrent DVT to determine if UI could reliably detect recurrent thrombosis. Six limbs had normal deep veins and 32 had evidence of previous DVT by both techniques. Acute thrombus was diagnosed by both UI and ACV in 9 limbs and by UI alone in an additional three limbs. New thrombus was found in 13 popliteal-proximal and 10 calf veins by UI; while ACV detected 12 popliteal-proximal and five new calf vein thromboses. UI is comparable to ACV in detecting recurrent thrombosis and may be particularly useful in assessing the calf veins.

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Clinical Factors in the Diagnosis of Deep Venous Thrombosis (DVT)

10.1055/s-0039-1687540 ◽

1979 ◽

Author(s):

A.N. Nicolaides ◽

D. Irving

Keyword(s):

Multivariate Analysis ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Multiple Regression ◽

Regression Equation ◽

Multiple Regression Equation ◽

Clinical Factors ◽

Ankle Oedema ◽

Very High ◽

Significant Factors

Local signs and clinical factors were recorded in 160 patients (177 limbs) with clinically suspected DVT studied with venography. Thrombi were present in 96 limbs. A multivariate analysis was performed on the data: extension of signs proximal to the knee, deep calf induration at the site of tenderness, hypotension, patient’s group (medical or surgical), and obvious cause of signs other than DVT were significant. Thigh tendernessthigh oedema, calf tenderness, ankle oedema, malignancy, Homan’s sign, chest infection and cardia failure were not significant. Using the significant factors a multiple regression equation was calculated. From this equation the probability of DVT could be obtained for any patient. In 20% of patients the probability of DVT was very small (<10%) and in 16% of patients it was very high (>90%) enabling the clinician to decide about the method of further investigation.

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Laboratory Evaluation and Clinical Characteristics of 2,132 Consecutive Unselected Patients with Venous Thromboembolism – Results of the Spanish Multicentric Study on Thrombophilia (EMET*-Study)

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655986 ◽

1997 ◽

Vol 77 (03) ◽

pp. 444-451 ◽

Cited By ~ 163

Author(s):

José Mateo ◽

Artur Oliver ◽

Montserrat Borrell ◽

Núria Sala ◽

Jordi Fontcuberta ◽

...

Keyword(s):

Venous Thrombosis ◽

Odds Ratio ◽

Protein C ◽

Protein S ◽

Laboratory Evaluation ◽

Clinical Factors ◽

Recurrent Thrombosis ◽

Heparin Cofactor Ii ◽

Crude Odds Ratio ◽

History Of

SummaryPrevious studies on the prevalence of biological abnormalities causing venous thrombosis and the clinical characteristics of thrombotic patients are conflicting. We conducted a prospective study on 2,132 consecutive evaluable patients with venous thromboembolism to determine the prevalence of biological causes. Antithrombin, protein C, protein S, plasminogen and heparin cofactor-II deficiencies, dysfibrinoge-nemia, lupus anticoagulant and antiphospholipid antibodies were investigated. The risk of any of these alterations in patients with familial, recurrent, spontaneous or juvenile venous thrombosis was assessed. The overall prevalence of protein deficiencies was 12.85% (274/2,132) and antiphospholipid antibodies were found in 4.08% (87/2,132). Ten patients (0.47%) had antithrombin deficiency, 68 (3.19%) protein C deficiency, 155 (7.27%) protein S deficiency, 16 (0.75%) plasminogen deficiency, 8 (0.38%) heparin cofactor-II deficiency and 1 had dysfib-rinogenemia. Combined deficiencies were found in 16 cases (0.75%). A protein deficiency was found in 69 of 303 (22.8%) patients with a family history of thrombosis and in 205/1,829 (11.2%) without a history (crude odds ratio 2.34, 95% Cl 1.72-3.17); in 119/665 (17.9%) patients with thrombosis before the age of 45 and in 153/1,425 (10.7%) after the age of 45 (crude odds ratio 1.81, 95% Cl 1.40-2.35); in 103/616 (16.7%) with spontaneous thrombosis and in 171/1,516 (11.3%) with secondary thrombosis (crude odds ratio 1.58, 95% Cl 1.21-2.06); in 68/358 (19.0%) with recurrent thrombosis and in 206/1,774 (11.6%) with a single episode (crude odds ratio 1.78,95% Cl 1.32-2.41). Patients with combined clinical factors had a higher risk of carrying some deficiency. Biological causes of venous thrombosis can be identified in 16.93% of unselected patients. Family history of thrombosis, juvenile, spontaneous and recurrent thrombosis are the main clinical factors which enhance the risk of a deficiency. Laboratory evaluation of thrombotic patients is advisable, especially if some of these clinical factors are present.

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Duplex doppler ultrasonography in the diagnosis of deep venous thrombosis of the lower extremities

Medicinski pregled ◽

10.2298/mpns0602011v ◽

2006 ◽

Vol 59 (1-2) ◽

pp. 11-14 ◽

Cited By ~ 2

Author(s):

Viktorija Vucaj-Cirilovic ◽

Kosta Petrovic ◽

Olivera Nikolic ◽

Viktor Till ◽

Dijana Niciforovic ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Doppler Ultrasonography ◽

Varicose Veins ◽

Color Doppler ◽

Lower Extremities ◽

Postthrombotic Syndrome ◽

Duplex Doppler ◽

Age Range

Introduction. The aim of this study was to investigate the role of duplex Doppler ultrasonography in diagnosis of deep venous thrombosis (DVT) of the lower extremities. Material and methods. During a 2-year period, 860 patients were examined by duplex Doppler sonography. Among these, 619(72%) were women and 241 (28%) men, with the age-range of 16-91; (mean 56,2) years. Siemens Versa Pro color doppler was used, with 7MHz transducers. Findings were categorized into four categories: 1. deep venous thrombosis (DVT); 2. pathology predominantly related to superficial veins without DVT; 3. pathology of superficial and deep veins; 4. normal findings. Results. 185 (21%) patients had DVT, 366 (42.5%) patients had pre?dominant pathology of superficial veins: postthrombotic syndrome, superficial thrombophlebitis and varicose veins. 128 (14.9%) patients had pathology of superficial and deep veins. Normal findings were found in 181 (21.1%) patients. Conclusions. Various vascular and nonvascular diseases may mimic deep venous thrombosis, and that is why US should be used whenever possible to avoid unnecessary anticoagulant therapy. .

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Duplex investigations in children: Are clinical signs in children with venous disorders relevant?

Phlebology The Journal of Venous Disease ◽

10.1177/0268355514556143 ◽

2014 ◽

Vol 30 (10) ◽

pp. 719-723

Author(s):

M Birgitte Maessen-Visch ◽

L Smeets ◽

C van Vleuten

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Varicose Veins ◽

Clinical Signs ◽

Patient Characteristics ◽

Duplex Sonography ◽

Chronic Venous Disease ◽

Ultra Sound ◽

Venous Disease ◽

Venous Disorders

Objectives Ultra sound colored duplex sonography is the preferred method in diagnosing chronic venous disease. Data in children on incidence, indications, and results are lacking. Methods From the total of 9180 duplex investigations performed in our hospital from 2009 to 2012, data on indication and results of the investigation as well as patient characteristics were evaluated retrospectively for the proportion of pediatric patients. Results Duplex investigations were performed 49 times in 38 children (6–18 years), with an average of 1.3 times (1–6 times) per child. Forty percent showed abnormalities: 17 times deep venous thrombosis was suspected; deep venous thrombosis was objectified in 18%. In the 21 investigations performed for varicosis-related complaints, varicose veins or venous malformations were objectified in 57%. Edema was never a symptom of chronic venous disease. Conclusions Duplex investigation is not often performed in children. In children with established deep venous thrombosis, a family history with deep venous thrombosis is common. In general, edema was not seen in children with varicose veins and, therefore, does not seem a reliable clinical sign at young age.

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Case 1.27

Mayo Clinic Body MRI Case Review ◽

10.1093/med/9780199915705.003.0027 ◽

2014 ◽

pp. 54-55

Author(s):

Christine U. Lee ◽

James F. Glockner

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Signal Intensity ◽

Pulmonary Emboli ◽

Axial Diffusion ◽

Weighted Image ◽

Hepatic Lobe ◽

P 75 ◽

History Of ◽

The Right

75-year-old woman with a history of deep venous thrombosis and pulmonary emboli Coronal SSFSE (Figure 1.27.1) and axial fat-suppressed FSE T2-weighted (Figure 1.27.2) images reveal a large exophytic mass projecting inferiorly from the right hepatic lobe, with a few scattered foci of mildly increased signal intensity. Axial diffusion-weighted image (b=400 s/mm...

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Fatal deep venous thrombosis and pulmonary embolism secondary to melioidosis in China: case report and literature review

BMC Infectious Diseases ◽

10.1186/s12879-019-4627-6 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Hua Wu ◽

Dongliang Huang ◽

Biao Wu ◽

Mengjie Pan ◽

Binghuai Lu

Keyword(s):

Pulmonary Embolism ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Fatal Case ◽

Therapeutic Interventions ◽

Case Presentation ◽

Reduce Mortality Rate ◽

Left Lower Extremity ◽

Appropriate Treatment ◽

History Of

Abstract Background Burkholderia pseudomallei is a gram-negative bacterium and the causative pathogen of melioidosis, which manifests a variety ranges of infection symptoms. However, deep venous thrombosis (DVT) and pulmonary embolism (PE) secondary to bacteremic melioidosis are rarely documented in the literature. Herein, we reported a fatal case of melioidosis combined with DVT and PE. Case presentation A 54-year-old male construction worker and farmer with a history of diabetes was febrile, painful in left thigh, swelling in left lower limb, with chest tightness and shortness of breath for 4 days. He was later diagnosed as DVT of left lower extremity and PE. The culture of his blood, sputum and bone marrow samples grew B. pseudomallei. The subject was administrated with antibiotics (levofloxacin, cefoperazone/tazobactam, and imipenem) according to antimicrobial susceptibility testing and low molecular heparin for venous thrombosis. However, even after appropriate treatment, the patient deteriorated rapidly, and died 2 weeks after admission. Conclusions This study enhanced awareness of the risk of B. pseudomallei bloodstream infection in those with diabetes. If a patient has predisposing factors of melioidosis, when DVT is suspected, active investigation and multiple therapeutic interventions should be implemented immediately to reduce mortality rate.

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Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study

Stroke Research and Treatment ◽

10.1155/2020/8610903 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Derya Uluduz ◽

Sevki Sahin ◽

Taskin Duman ◽

Serefnur Ozturk ◽

Vildan Yayla ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Sinus Thrombosis ◽

Previous History ◽

Epileptic Seizures ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

History Of ◽

The Mean

Background. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results. The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34±9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38±9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

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