Predicting Post-Thrombotic Syndrome with Ultrasonographic Follow-Up after Deep Vein Thrombosis: A Systematic Review and Meta-Analysis
| Autor: | Cecilia Becattini, Charlotte E.A. Dronkers, Menno V. Huisman, Frederikus A. Klok, Gerben C. Mol, G. Maraziti, M.A. van de Ree |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Deep vein Clinical Decision-Making 030204 cardiovascular system & hematology Risk Assessment Postthrombotic Syndrome 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine Humans Medicine meta-analysis post-thrombotic syndrome ultrasonography venous thrombosis Aged Female Middle Aged Patient Selection Prognosis Reproducibility of Results Stockings Compression Venous Thrombosis Ultrasonography Stockings 030212 general & internal medicine Prospective cohort study business.industry Compression Hematology Odds ratio medicine.disease Thrombosis Venous thrombosis medicine.anatomical_structure Predictive value of tests Meta-analysis business Post-thrombotic syndrome |
| Zdroj: | Thrombosis and Haemostasis, 118(8), 1428-1438 |
| Popis: | Background Post-thrombotic syndrome (PTS) is a common and potential severe complication of deep venous thrombosis (DVT). Elastic compression stocking therapy may prevent PTS if worn on a daily basis, but stockings are cumbersome to apply and uncomfortable to wear. Hence, identification of predictors of PTS may help physicians to select patients at high risk of PTS. Aims This article identifies ultrasonography (US) parameters assessed during or after treatment of DVT of the leg, that predict PTS. Methods This is a systematic review and meta-analysis study. Databases were searched for prospective studies including consecutive patients with DVT who received standardized treatment, had an US during follow-up assessing findings consistent with vascular damage after DVT and had a follow-up period of at least 6 months for the occurrence of PTS assessed by a standardized protocol. Results The literature search revealed 1,156 studies of which 1,068 were irrelevant after title and abstract screening by three independent reviewers. After full-text screening, 12 relevant studies were included, with a total of 2,684 analysed patients. Two US parameters proved to be predictive of PTS: residual vein thrombosis, for a pooled odds ratio (OR) of 2.17 (95% confidence interval [CI], 1.79–2.63) and venous reflux at the popliteal level, for a pooled OR of 1.34 (95% CI, 1.03–1.75). Conclusion The US features reflux and residual thrombosis measured at least 6 weeks after DVT predict PTS. Whether these features may be used to identify patients who may benefit from compression therapy remains to be assessed in further studies. |
| Databáze: | OpenAIRE |
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