Incidence and characteristics of asymptomatic distal deep vein thrombosis unexpectedly found at admission in an Internal Medicine setting

Ciuti, Gabriele; Grifoni, Elisa; Pavellini, Andrea; Righi, D.; Livi, R.; Perfetto, Federico; Abbate, Rosanna; Prisco, Domenico; Pignone, Alberto Moggi

doi:10.1016/j.thromres.2012.05.018

Cited by 17 publications

(11 citation statements)

References 30 publications

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“…Our study showed a high incidence (14.7%) of asymptomatic DVT in a cohort of patients admitted in non-intensive care units with COVID-19 pneumonia. However, this incidence is similar to that reported in other recent study about asymptomatic DVT in internal medicine setting (16.2%) [12] and even lower than that reported in orthopedic surgery setting [13,14]. Of note, patients in our study had an expectedly high thrombotic risk, since median days of admission was 9 and all patients had COVID-19 pneumonia and a cut-off D-dimer level of 1000 ng/ml.…”

Section: Discussionsupporting

confidence: 90%

Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels

Demelo‐Rodríguez

Cervilla-Muñoz

Ordieres‐Ortega

et al. 2020

Thrombosis Research

308

385

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An increased risk of venous thromboembolism (VTE) in patients with COVID-19 pneumonia admitted to intensive care unit (ICU) has been reported. Whether COVID-19 increases the risk of VTE in non-ICU wards remains unknown. We aimed to evaluate the burden of asymptomatic deep vein thrombosis (DVT) in COVID-19 patients with elevated D-dimer levels. Method: In this prospective study consecutive patients hospitalized in non-intensive care units with diagnosis of COVID-19 pneumonia and D-dimer > 1000 ng/ml were screened for asymptomatic DVT with complete compression doppler ultrasound (CCUS). The study was approved by the Institutional Ethics Committee. Results: The study comprised 156 patients (65.4% male). All but three patients received standard doses of thromboprophylaxis. Median days of hospitalization until CCUS was 9 (IQR 5-17). CCUS was positive for DVT in 23 patients (14.7%), of whom only one was proximal DVT. Seven patients (4.5%) had bilateral distal DVT. Patients with DVT had higher median D-dimer levels: 4527 (IQR 1925-9144) ng/ml vs 2050 (IQR 1428-3235) ng/ml; p < 0.001. D-dimer levels > 1570 ng/ml were associated with asymptomatic DVT (OR 9.1; CI 95% 1.1-70.1). D-dimer showed an acceptable discriminative capacity (area under the ROC curve 0.72, 95% CI 0.61-0.84). Conclusion:In patients admitted with COVID-19 pneumonia and elevated D-dimer levels, the incidence of asymptomatic DVT is similar to that described in other series. Higher cut-off levels for D-dimer might be necessary for the diagnosis of DVT in COVID-19 patients. The aim of our study was to evaluate the burden of asymptomatic

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Section: Discussionsupporting

confidence: 90%

Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels

Demelo‐Rodríguez

Cervilla-Muñoz

Ordieres‐Ortega

et al. 2020

Thrombosis Research

308

385

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“…[1][2][3] VTE has been detected in 3 to 46% of the patients with COVID-19, with the highest prevalence in patients in intensive care units (ICU). [4][5][6][7][8][9][10][11][12][13][14][15][16][17] These rates are higher than those reported in non-COVID-19 patients [18][19][20] and have been related to a higher mortality. 5 The diagnosis of VTE in patients with COVID-19 is challenging because its clinical manifestations and analytical findings can be misdiagnosed.…”

Section: Introductionmentioning

confidence: 70%

Estimation of Admission D-dimer Cut-off Value to Predict Venous Thrombotic Events in Hospitalized COVID-19 Patients: Analysis of the SEMI-COVID-19 Registry

et al. 2021

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“…24 Nearly all our patients who had normal CDUS were asymptomatic (96.3%, 26/27) which reflects existing literature. 11,13,15,22,23,25 Ciuti et al observed a prevalence of 20.7% for asymptomatic DVT 26 while an observational study of 1,071 patients reported 1.8%. 27 In the blind prospective CALTHRO study, 85% of outpatients with symptoms of DVT and abnormal D-dimer levels did not have DVT on whole leg color Doppler ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“…25 Distal DVT is associated with transient risk factors such as recent trauma, immobilization, long haul travel, and preexisting leg varicosities rather than advanced age, pregnancy, prior VTE, or active cancer. 25,26 Our patients presented 7 to 90 days postfracture with ankle or foot immobilization and distal DVT is known to develop and propagate within this time. 1,[28][29][30] The CALTHRO study suggested only 3% of isolated distal DVT extend proximally and over 90% resolve by 3 months.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Acute Deep Vein Thrombosis in Patients with Ankle and Foot Fractures Treated with Nonoperative Management—A Pilot Study

Omari

2015

Int J Angiol

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The prevalence of deep vein thrombosis (DVT) among patients with ankle and foot fractures in Australia treated nonsurgically is unknown. Indications for thromboprophylaxis screening and management are unclear. The primary outcome was the prevalence rate of DVT among nonsurgically managed ankle and foot fracture patients. Patients were enrolled into a prospective cross-sectional pilot study at an outpatient hospital fracture clinic. DVT risk factors and symptoms were recorded at time of recruitment followed by referral for compression duplex ultrasonography. Independent t-test and Fisher exact test were used to assess the significance of these variables with DVT. A total of 72 patients were included in the final analysis. Overall, 11% (8/72) of patients had DVT?seven distal DVTs and one proximal DVT. Four were symptomatic including the patient with a proximal thrombus. In comparison, the majority of patients were asymptomatic of DVT (63/72). A significant risk factor found to be associated with DVT was age???45 (p?=?0.013) years, and a lack of symptoms (p?=?0.006) was associated with no DVT. This pilot study is the first in Australia to investigate the prevalence of DVT in this specific subgroup of patients. We found a prevalence of 11% of DVT in a small group of patients with age???45 years, being the only significant associated risk factor. Future larger scale prospective studies are warranted to confirm these results.

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Incidence and characteristics of asymptomatic distal deep vein thrombosis unexpectedly found at admission in an Internal Medicine setting

Cited by 17 publications

References 30 publications

Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels

Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels

Estimation of Admission D-dimer Cut-off Value to Predict Venous Thrombotic Events in Hospitalized COVID-19 Patients: Analysis of the SEMI-COVID-19 Registry

Prevalence of Acute Deep Vein Thrombosis in Patients with Ankle and Foot Fractures Treated with Nonoperative Management—A Pilot Study

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