Diagnosis of Deep-Vein Thrombosis: Comparison of Clinical Evaluation, Ultrasound, Plethysmography, and Venoscan With X-Ray Venogram

Sandler, DavidA.; Duncan, John S.; Ward, Peter; Lamont, AnthonyC.; Sherriff, S B; Jf, Martín; Blake, GlenM.; Ramsay, L. E.; Ross, Brian M.; Walton, Lee

doi:10.1016/s0140-6736(84)92625-4

Cited by 127 publications

(36 citation statements)

References 34 publications

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“…14 Clinical suspicion of DVT confirmed by complementary phlebography examination was 40%, reported by Richards. 15 Sandler et al 16 found 58% and Rollo et al 17 performed a phlebographic study in 424 patients with suspicion of DVT and found 68.6% of patients with confirmed diagnosis of DVT.…”

Section: Introductionmentioning

confidence: 99%

Avaliação da utilização de profilaxia da trombose venosa profunda em um hospital escola

et al. 2007

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RESUMOContexto: A trombose venosa profunda (TVP) é uma doença freqüente e grave. A profilaxia é o melhor meio para reduzir a sua incidência, diminuindo a morbimortalidade gerada por suas complicações. Na relação custo x efetividade, é melhor manter uma rotina profilática do que tratar a doença já instalada. Objetivo: Verificar se a profilaxia da TVP está sendo utilizada de maneira adequada e rotineira no Hospital Escola Doutor José Carneiro (HEJC), de Maceió (AL). Métodos: Foi realizado um estudo transversal descritivo no HEJC durante o período de 6 meses. A amostra foi de 298 pacientes, de diferentes especialidades. Os dados foram coletados nos prontuários, divididos em clínicos (68,5%) e cirúrgicos (31,5%). Analisou-se, em cada paciente, como se procedeu a utilização da profilaxia para a TVP. Foram pesquisados fatores clínicos, medicamentosos e cirúrgicos para todos os pacientes e, com base nesses dados, foi realizada estratificação do risco conforme a classificação recomendada pela Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV). O estudo estatístico foi realizado através do software SPSS, utilizando os testes qui-quadrado e de correção bivariada, considerando o valor de p < 0,05. Resultados: Dos 298 pacientes analisados, 204 eram da clínica médica, onde 28,9% eram de baixo risco, 60,3% médio risco e 10,8% alto risco para TVP; e 94 pacientes eram da clínica cirúrgica, onde 43,6% apresentaram baixo risco, 52,1% médio risco e 4,3% alto risco. Apenas 23% dos pacientes do grupo clínico e 2,1% para o grupo cirúrgico receberam a profilaxia de forma adequada.Conclusão: Apesar da eficácia da profilaxia para a TVP já ter sido comprovada e difundida, em nosso meio ainda não atinge os níveis desejados de utilização. Palavras-chave:Prevenção e controle, trombose venosa, avaliação. ABSTRACTBackground: Deep venous thrombosis (DVT) is a frequent and severe disease. Prophylaxis is the best means to reduce its incidence, lowering morbidity and mortality rates caused by its complications. In a cost-effectiveness ratio, it is better to maintain a prophylactic routine than to treat an established disease. Objective: To verify whether DVT prophylaxis is being properly and routinely used at Hospital Escola Doutor José Carneiro (HEJC), in Maceió, Brazil. Methods: A descriptive, cross-sectional study at HEJC was carried out for a 6-month period. The sample was composed of 298 patients within different specialties. Data were collected from medical records, and divided into clinical (68.5%) and surgical (31.5%). How DVT prophylaxis was performed was analyzed for each patient. Clinical, pharmacological and surgical factors were investigated for all patients. Based on these data, risk stratification was performed in accordance with the classification recommended by Sociedade Brasileira de Angiologia e Cirurgia Vascular. Statistical analysis was performed using software SPSS and the qui-square and bivariate correction tests, considering p value < 0.05. Results: Of the 298 patients analyzed, 204 belonged to medical clinic, ...

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Section: Introductionmentioning

confidence: 99%

Avaliação da utilização de profilaxia da trombose venosa profunda em um hospital escola

et al. 2007

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“…1,2 Objective testing for DVT is crucial because clinical assessment alone is unreliable, [3][4][5][6] and the consequences of misdiagnosis are serious, including fatal pulmonary embolism (PE). 7,8 Although anticoagulant therapy is effective, 9 its unnecessary use entails expense, inconvenience, and risk of major hemorrhage.…”

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confidence: 99%

Diagnosis of DVT

Bates

Jaeschke

Stevens

et al. 2012

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566

192

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“…The sensitivity of ultrasonic Doppler technique and plethysmography is insufficient (Hachen, 1974;Holden, 198 1;Sandler, 1984). The use ofl125 radiolabelled fibrinogen is a difficult technique and its sensitivity can be excessive; on the other hand, it may not detect an organised thrombus.…”

Section: Discussionmentioning

confidence: 99%

Systematic lower limb phlebography in acute spinal cord injury in 147 patients

et al. 1991

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SummaryThis study was concluded on paraplegic and tetraplegic patients of all aetiologies except neoplasic, where paralysis developed within 48 hours. All patients were admitted to the rehabilitation department within 90 days after the onset of paralysis. In a preliminary review of 328 files, there were 27 cases of clinical deep vein thrombosis (DVT) and 10 with pulmonary embolism (PE), 6 of which were fatal. A prospective study was conducted, based on systematic detection of asymptomatic DVT with phlebography. Among the 147 patients, 20 previously presented with DVT. The 127 others underwent phlebography which showed 39 DVT in 29 patients. Eighty seven patients with negative phlebography underwent a second study a month later which showed 14 DVT in 12 patients. Only one minor pulmonary embolism occurred in these 147 patients. The incidence of DVT after acute spinal cord injury and the frequent absence of clinical manifestations were confirmed. Prophylactic anticoagulant therapy is useful but insufficient. This study demonstrates that systematic and repeated detection of DVT by phlebography may reduce the incidence of P E.

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Diagnosis of Deep-Vein Thrombosis: Comparison of Clinical Evaluation, Ultrasound, Plethysmography, and Venoscan With X-Ray Venogram

Cited by 127 publications

References 34 publications

Avaliação da utilização de profilaxia da trombose venosa profunda em um hospital escola

Avaliação da utilização de profilaxia da trombose venosa profunda em um hospital escola

Diagnosis of DVT

Systematic lower limb phlebography in acute spinal cord injury in 147 patients

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