Proximal and isolated distal deep vein thrombosis and Wells score accuracy in hospitalized patients

Autor: Massimo Filippini, Michelangelo Sartori, Elisabetta Favaretto, Ludovica Migliaccio, Benilde Cosmi, Filippo Gabrielli
Přispěvatelé: Academic Medical Center, Vascular Medicine, Sartori M., Gabrielli F., Favaretto E., Filippini M., Migliaccio L., Cosmi B.
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Hospitalized patients
Deep vein
030204 cardiovascular system & hematology
Calf deep vein thrombosi
Calf deep vein thrombosis
Deep vein thrombosis
Diagnosis
Inpatients
Isolated distal deep vein thrombosis
03 medical and health sciences
0302 clinical medicine
Text mining
Deep vein thrombosi
Internal medicine
Internal Medicine
medicine
Prevalence
Humans
cardiovascular diseases
030212 general & internal medicine
Aged
Aged
80 and over
Venous Thrombosis
Receiver operating characteristic
business.industry
Incidence (epidemiology)
Middle Aged
University hospital
medicine.disease
Thrombosis
Surgery
Pre- and post-test probability
Hospitalization
medicine.anatomical_structure
Cross-Sectional Studies
ROC Curve
Research Design
Emergency Medicine
Female
Inpatient
business
Wells score
Diagnosi
Zdroj: Internal and emergency medicine, 14(6), 901-902.. Springer-Verlag Italia
ISSN: 1828-0447
Popis: Deep vein thrombosis (DVT) is an important cause of morbidity and mortality in hospitalized patients. The Wells score for DVT pretest probability (PTP) was validated in outpatients, but its utility for inpatients is unclear. The aim of this study was to establish the prevalence of inpatient proximal and distal DVT and the Wells score performance in inpatients. A single-center cross-sectional study was conducted in a university hospital. During 183days, all inpatients with suspected lower-extremity DVT were evaluated with the Wells score and whole-leg ultrasound. Among 634 inpatients (age 77.5 ± 13.8 years, males 39.3%), 507 (80.0%) were from medical wards and 127 (20.0%) from surgical wards. During the study period, there were 11,662 hospital admissions in the surgical/medical services. Whole-leg ultrasound detected 128 DVTs (20.2%); 51 (39.8%) were proximal and 77 (60.1%) were isolated distal DVTs. Estimated DVT prevalence in hospital setting was 1.09% (95% CI 0.93–1.31), and isolated distal DVT prevalence was 0.66% (95% CI 0.53–0.82). DVT frequency in low-, moderate-, and high-PTP groups was 9.8%, 24.3%, and 41.5%, respectively (p = 0.001). The area under the receiver operating characteristic curve for the Wells score was 0.67 ± 0.03 for all DVTs and 0.75 ± 0.04 for only proximal DVTs. A high PTP had a sensitivity of 24% (95% CI 14–37%) and a specificity of 93% (95% CI 91–95%) for proximal DVT diagnosis. In hospitalized patients, isolated distal DVT has a higher incidence than expected, and the Wells score accuracy for proximal DVT is similar to that found in outpatients.
Databáze: OpenAIRE
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