Summary: Background: The aim of our study was to assess how often deep vein thrombosis (DVT) occurs bilaterally and if this has an impact on the recurrence rate of thromboembolic disease and on the occurrence of malignant tumors. Additionally, the occurrence of pulmonary embolism and mortality of patients was assessed. Patients and methods: For this observational study, we retrospectively screened all patient’s records for DVT, investigated between 2000 and 2017. 2409 patients with the diagnosis of DVT were found. The patients aged between 18 and 89 years old in 2017, received a follow-up questionnaire, asking for thromboembolic recurrence, malignant tumors and pulmonary embolism. 755 patients were included in the follow-up cohort (604 with unilateral, 151 with bilateral DVT). We performed nonparametric tests to assess two group analysis. Results: Bilateral DVT occurred in 19% of the patients in this cohort. Patients with bilateral DVT develop significantly more often cancer, either at the time of diagnosis or in the follow up, compared to patients with unilateral DVT (22.5% vs. 15.4%, p=0.036). They also endure significantly more often pulmonary embolism simultaneously (33.8% vs. 20.8%, p<0.001). Patients with bilateral DVT were significantly older (median 69 years) than patients with unilateral DVT (median 63 years, p<0.001). In addition, patients with bilateral DVT show a higher mortality (9.1% vs. 5.2%, p=0.002), a higher recurrence rate could not be observed. Conclusions: Bilateral DVT is more common than published so far. Patients with bilateral DVT suffer more often from malignant tumors, and are more often diagnosed with pulmonary embolism. The patients with bilateral DVT are older and have a higher mortality. Further investigations should address the issue of recurrent thromboembolic disease in a prospective cohort study.
Zusammenfassung. Das postthrombotische Syndrom ist definiert durch klinische Zeichen (objektiv erhobene Befunde) und Beschwerden, welche nach einer tiefen Beinvenenthrombose auftreten. Am häufigsten wird der Villalta Score angewendet. Am einfachsten anwendbar ist aber der Ginsberg Score (Schmerzen, Schwellung > 1 Monat), letzterer scheint bezüglich Sensitivität mit dem Villalta Score vergleichbar zu sein. Die aktuell in der Literatur beschriebenen Scores sind leider nicht spezifisch und werden in den verschiedenen Studien unterschiedlich verwendet. Entsprechend variieren auch die Prävalenzen des postthrombotischen Syndroms (3 – 23 %). Der natürliche Verlauf einer tiefen Beinvenenthrombose unter Antikoagulation und das Auftreten eines postthrombotischen Syndromes sind wichtige Prädiktoren für den Langzeitverlauf des Beschwerdebildes. Vier grosse kontrollierte Studien haben den Effekt der Kompression auf die Entwicklung eines postthrombotischen Syndroms geprüft, diese Studien werden zusammengefasst und diskutiert, die Rolle der Kompressionstherapie wird kritisch hinterfragt. Die duplexsonographischen Befunde wie der Rest – Thrombusload und der postthrombotisch auftretende venöse Reflux haben bei einer prospektiv angelegten Studie keinen sicheren prädiktiven Wert für die Voraussage eines postthrombotischen Syndroms gezeigt.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.