How do we know who has had deep vein thrombosis?

Abstract

Summary:An attempt was made to identify all patients diagnosed as having deep vein thrombosis (DVT) in a large teaching hospital during one year. A review of the radiology records showed that 124 (81%) of the 154 venograms performed were for suspected DVT, and that the diagnosis was confirmed in 57 (46%). During the same period, the Hospital Activity Analysis (HAA) records revealed 174 episodes classified as 'phlebitis or thrombophlebitis' in 162 patients. Only 37 of these episodes (21%) had been confirmed by X-ray venography and at least 29 patients were incorrectly classified by HAA. 'Medical' patients accounted for 54% of the episodes of DVT, yet in only 25% of these was the diagnosis confirmed by venography, while 'surgical' DVTs were less frequent but were more often confirmed by venography.

The value of colour duplex imaging in suspected proximal deep vein thrombosis of the leg

“…The accuracy of clinical diagnosis of DVT was only 17/35 (50%) and similiar to those reported else where (4,5,6,7). Screening for DVT has shown that up to 65% of proximal DVT is asymptomatic and the diagnosis would not even be considered (14).…”

“…These drugs with their potential for serious haemorrhagic complications cannot be started or continued for long periods without an accurate diagnosis. Clinical diagnosis of DVT is unreliable (4,5,6,7) and therefore an objective test for accu rate assessment becomes necessary. Contrast venography is recognized as the gold standard examination.…”