Diagnosis of deep-vein thrombosis: Adherence to guidelines and outcomes in real-world health care

2009 ◽  
Vol 102 (12) ◽  
pp. 1234-1240 ◽  
Author(s):  
Horst Gerlach ◽  
Viola Hach-Wunderle ◽  
Eberhard Rabe ◽  
Hanno Riess ◽  
Heike Carnarius ◽  
...  
Keyword(s):  
Health Care ◽  
Deep Vein Thrombosis ◽  
Ambulatory Care ◽  
Real World ◽  
Diagnostic Methods ◽  
World Health ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Work Up ◽  
Current Guidelines

SummaryCurrent guidelines recommend optimised algorithms for diagnosis of suspected deep-vein thrombosis (DVT). There is little data to determine to what extent real-world health care adheres to guidelines, and which outcome in terms of diagnostic efficiency and safety is achieved. This registry involved patients with clinically suspected DVT of the leg recruited in German ambulatory care between October and December 2005. Registry items were: diagnostic methods applied; diagnostic categories at day 1; and venous thromboembolic events up to 90 days in patients without firmly established DVT. A total of 4,976 patients were recruited in 326 centres. Venous ultrasonography was performed in 4,770 patients (96%), D-dimer assay in 1,773 patients (36%) and venography in 288 patients (6%). At day 1, DVT was confirmed in 1,388 patients (28%), and ruled out in 3,389 patients (68%), and work-up was inconclusive in 199 patients (4%).The rate of venous thromboembolism at 90 days was 0.34% (95% confidence interval [CI]: 0.09 to 0.88) in patients in whom the diagnosis of DVT had been ruled out, and 2.50% (95% CI: 0.69 to 6.28) in patients with inconclusive diagnostic workup. This nationwide evaluation in German ambulatory care revealed that the diagnostic work-up for suspected DVT did not adhere to current guidelines. However, the overall diagnostic safety was excellent, although there is potential for improvement in a well defined minority of patients.The TULIPA registry was funded by GlaxoSmithKline GmbH und Co KG, Munich.

Cancer and Peripheral Deep Vein Thrombosis are Both Independent Diseases Causes, Pathogenesis, Conclusions

2020 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Drozdova Elena Viktorovna ◽  
Keyword(s):  
Deep Vein Thrombosis ◽  
World Health Organization ◽  
Cause Of Death ◽  
Controlled Trial ◽  
World Health ◽  
Peripheral Vein ◽  
Vein Thrombosis ◽  
Sickness Rate ◽  
Health Organization ◽  
Deep Vein

There is an undisputed thesis: CANCER has an often COMPLICATION such as DEEP VEIN THROMBOSIS. Cancer is the second leading cause of death globally, and is responsible for an estimated 9.6 million deaths in 2018. (according to World Health Organization). Sickness rate of deep vein thrombosis is approximately 100 per 100 000 population annually. Sickness rate of cancer in different countries is approximately 130-500 per 100 000 population annually. Thus, if deep vein thrombosis is considered to be a complication of cancer we must identify both these diseases simultaneously with frequency of 20 -76.9% The Research Objective To determine whether peripheral vein thromboses are the complications of cancer. The Method of the Research Randomized prospective parallel controlled trial.

scholarly journals A Case Study of Deep Vein Thrombosis of the Right Internal Jugular Vein in a Healthy 21-Year-Old Male

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Javier Corral ◽  
Geri Villanueva
Keyword(s):  
Deep Vein Thrombosis ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Significant Past Medical History ◽  
Vein Thrombosis ◽  
The Right ◽  
Deep Vein ◽  
Work Up

We are reporting a case of a healthy 21-year-old male, with no significant past medical history, who was found to have an incidental nonocclusive deep vein thrombosis in the right internal jugular vein detected on a head MRI previously ordered for work-up of headaches. A follow-up upper extremity venous Doppler ultrasound confirmed the presence of a partially occlusive deep vein thrombosis in the right jugular vein. The case presented is unique for the reason that the patient is young and has no prior risk factor, personal or familial, for venous thrombosis except for associated polycythemia on clinical presentation.

A new rapid bedside assay for quantitative testing of D-Dimer (Cardiac D-Dimer) in the diagnostic work-up for deep vein thrombosis

2003 ◽  
Vol 111 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Cristina Legnani ◽  
Simone Fariselli ◽  
Michela Cini ◽  
Gaetana Oca ◽  
Carmela Abate ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Diagnostic Work ◽  
Deep Vein ◽  
Work Up ◽  
Diagnostic Work Up ◽  
D Dimer

scholarly journals Deep Vein Thrombosis, Demographic Characteristics and Risk Factors in Iran

2013 ◽  
Vol 2 (4) ◽  
pp. 135-140
Author(s):  
Shokoufeh Hajsadeghi ◽  
Scott Reza Jafarian Kerman ◽  
Rashin Joodat ◽  
Maral Hejratie ◽  
Helen Vaferi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Deep Vein Thrombosis ◽  
Health Care Systems ◽  
Care Providers ◽  
Female Ratio ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Care Systems ◽  
Deep Vein

Background: Deep vein thrombosis (DVT) can be an ethnicity related disease and an important health issue for health-care systems. Thus, domestic recognition of risk factors and disease characteristics seem to be inevitable. This study was designed to evaluate the epidemiology, basic characteristics, and risk factors in patients with DVT.Materials and Methods: In this descriptive cross-sectional study, all patients with primary or final diagnosis of DVT, confirmed by Doppler ultrasound in a 5-year period were included. Demographic data and prognosis were extracted from medical files. To evaluate the outcome of the patients after discharge, a phone-call follow-up was performed for all available patients.Results: Three-hundred seventy-one DVT patients were included with 232/139 male to female ratio. The mean age was 55.72±20.01 years with significant difference between genders (p=0.006). Mean weight was 88.97±10.2 kg with no significant difference between genders (p=0.74). The most common affected veins were common femoral vein (257 cases, 69.2%), followed by Popliteal, iliac, axillary, and subclavian veins. No season preference was seen in DVT occurrence. One-year survival of the patients after discharge was 92.6% and two-year survival was 87.7%.Conclusion: By knowing local information about this disease, health-care providers can give accurate warnings and suggestions to prevent the probable thrombosis chances. As Iran lacked information about DVT characteristics, this study can be an epidemiologic guide for health-care systems and an opening path for future studies.

Imaging for venous thrombosis

ESC CardioMed ◽  
2018 ◽  
pp. 2806-2810
Author(s):  
Frederikus A. Klok ◽  
Charlotte E. A. Dronkers ◽  
Menno V. Huisman
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Imaging Techniques ◽  
Clinical Decision ◽  
Cerebral Vein ◽  
Vein Thrombosis ◽  
Diagnostic Work ◽  
Deep Vein ◽  
Work Up ◽  
Test Probability

The diagnostic work-up of upper and of lower extremity deep vein thrombosis starts with the assessment of the pre-test probability by using a validated clinical decision rule, followed by imaging if deep vein thrombosis cannot reliably be rule out. For splanchnic vein thrombosis and cerebral vein thrombosis, the diagnostic assessment starts with imaging. Currently, the imaging techniques most widely used in clinical practice are compression ultrasonography, computed tomography, and magnetic resonance imaging, with a diagnostic standard dependent on the specific site of the venous thrombosis. This chapter provides an overview of the diagnostic accuracy and potential pitfalls of imaging techniques for the different sites of venous thrombosis.

Impact of gender on the clinical presentation and diagnosis of deep-vein thrombosis

2010 ◽  
Vol 103 (04) ◽  
pp. 710-717 ◽  
Author(s):  
Hanno Riess ◽  
Viola Hach-Wunderle ◽  
Horst Gerlach ◽  
Heike Carnarius ◽  
Sonja Eberle ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Presentation ◽  
Risk Groups ◽  
Pretest Probability ◽  
Probability Score ◽  
Vein Thrombosis ◽  
Diagnostic Work ◽  
Deep Vein ◽  
Work Up ◽  
Diagnostic Work Up

SummaryIt is uncertain whether gender influences the clinical presentation of deep-vein thrombosis (DVT) and the discriminative value of the Wells diagnostic pretest probability score. The aim of the study was to determine whether gender impacts the clinical presentation and diagnosis of DVT. The study analysed a cohort of 4,976 outpatients with clinically suspected DVT of the leg prospectively recruited by 326 vascular medicine physicians in the German ambulatory care sector between October and December 2005. The diagnosis of DVT was based on compression ultrasonography in 96% of patients. Among 4,777 patients who had a diagnostic work-up for DVT there were more women (n=2,998) than men (n=1,779). However, the prevalence of confirmed DVT was 37.0% (658/1779) in men vs. 24.3% (730/2,998) in women (p<0.001). Among patients with confirmed DVT, proximal DVT was more common in men (59.6% vs. 44.5% in women, p<0.001). Swelling of the leg, pitting oedema and dilated superficial veins were more frequently reported by men (p<0.001). The percentage of patients with a high probability Wells clinical pretest score was higher in men than in women (67.0% vs. 57.0%, p<0.001). However, overall, the score equally discriminated risk groups for DVT in both sexes. In conclusion, women were more frequently referred for a diagnostic work-up for DVT than men, but the prevalence of DVT was higher in men and their thrombotic events were more severe. Nevertheless, the Wells clinical pretest probability score correctly identified low- and high-risk groups in both genders.

Vasculitis due to Candidatus Neoehrlichia mikurensis: A Cohort Study of 40 Swedish Patients

2020 ◽  
Author(s):  
Linnea Höper ◽  
Elisabet Skoog ◽  
Martin Stenson ◽  
Anna Grankvist ◽  
Linda Wass ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Vascular Complications ◽  
Infectious Agent ◽  
Diagnostic Methods ◽  
Thromboembolic Events ◽  
Vascular Events ◽  
Northern Asia ◽  
Vein Thrombosis ◽  
Doxycycline Treatment ◽  
Deep Vein

Abstract Background Candidatus (Ca.) Neoehrlichia (N.) mikurensis is an emerging tick-borne pathogen of humans that is closely related to Ehrlichia and Anaplasma species. This strict intracellular bacterium escapes detection by routine microbiologic diagnostic methods such as blood culture, leading to considerable under-diagnosis of the infectious disease it causes, neoehrlichiosis. Methods Here, we describe the vascular and thromboembolic events afflicting a series of 40 patients diagnosed with neoehrlichiosis in Sweden during a 10-year period (2009–2019). Results The majority of the patients (60%) developed vascular events ranging from repeated thrombophlebitis, deep vein thrombosis, pulmonary embolism, transitory ischemic attacks, to arteritis. Younger age was a risk factor for vascular complications. In contrast, there was no difference in the incidence of vascular events between immunosuppressed and immunocompetent patients. However, there were qualitative differences, such that deep vein thrombosis exclusively afflicted the immunosuppressed patients, whereas arteritis was restricted to the immunocompetent persons. We also present the case histories of two patients who developed vasculitis mimicking polyarteritis nodosa and giant cell arteritis. Both were cured by doxycycline treatment. Conclusions Ca. N. mikurensis infection should be considered in patients living in tick-endemic areas of Europe and northern Asia who present with atypical vascular and/or thromboembolic events. Early diagnosis and antibiotics targeting this emerging infectious agent can eradicate the infection and prevent the development of new vascular events.

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