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 |
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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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