Probability of developing proximal deep-vein thrombosis and/or pulmonary embolism after distal deep-vein thrombosis
| Autor: | Aryeh Shapiro, Michael B. Rothberg, Rajesh Kumar, Joshua Allen, Linda Amah, Pojchawan Yampikulsakul, Neha Gupta, Andrei Brateanu, Lillie Morgan, Krishna Patel, Gautam V Shah, Sintawat Wangsiricharoen, Craig Nielsen, Kevin Chagin, Pichapong Tunsupon |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Deep vein 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Risk Factors Thromboembolism Odds Ratio medicine Humans Vein Aged Probability Retrospective Studies Venous Thrombosis business.industry Incidence Incidence (epidemiology) Anticoagulants Retrospective cohort study Hematology Odds ratio Middle Aged medicine.disease Thrombosis Pulmonary embolism Surgery Venous thrombosis medicine.anatomical_structure 030228 respiratory system Multivariate Analysis Regression Analysis Female Radiology Pulmonary Embolism Tomography X-Ray Computed business |
| Zdroj: | Thrombosis and Haemostasis. 115:608-614 |
| ISSN: | 2567-689X 0340-6245 |
| DOI: | 10.1160/th15-06-0503 |
| Popis: | SummaryIsolated distal deep-vein thrombosis (DDVT) of the lower extremities can be associated with subsequent proximal deep-vein thrombosis (PDVT) and/or acute pulmonary embolism (PE). We aimed to develop a model predicting the probability of developing PDVT and/or PE within three months after an isolated episode of DDVT. We conducted a retrospective cohort study of patients with symptomatic DDVT confirmed by lower extremity vein ultrasounds between 2001–2012 in the Cleveland Clinic Health System. We reviewed all the ultrasounds, chest ventilation/perfusion and computed tomography scans ordered within three months after the initial DDVT to determine the incidence of PDVT and/or PE. A multiple logistic regression model was built to predict the rate of developing these complications. The final model included 450 patients with isolated DDVT. Within three months, 30 (7%) patients developed an episode of PDVT and/or PE. Only two factors predicted subsequent thromboembolic complications: inpatient status (OR, 6.38; 95 % CI, 2.17 to 18.78) and age (OR, 1.02 per year; 95 % CI, 0.99 to 1.05). The final model had a bootstrap bias-corrected c-statistic of 0.72 with a 95 % CI (0.64 to 0.79). Outpatients were at low risk ( 10%). Inpatients aged < 60 were at intermediate risk. We created a simple model that can be used to risk stratify patients with isolated DDVT based on inpatient status and age. The model might be used to choose between anticoagulation and monitoring with serial ultrasounds. |
| Databáze: | OpenAIRE |
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