INDIVIDUAL AND CLINICAL PREDICTORS OF THE TIMING OF DIAGNOSIS OF VENOUS THROMBOEMBOLISM: RESULTS FROM THE MASTER REGISTRY
Abstract number: P-S-569
Ageno1 W., Agnelli2 G., Imberti3 D., Moia4 M., Palareti5 G., Pistelli6 R., Rossi2 R., Verso2 M.
11Clinical Medicine, University of Insubria, Varese 22Internal Medicine, University of Perugia, Perugia 33Internal Medicine, Piacenza Hospital, Piacenza 44Internal Medicine, Maggiore Hospital, Milan 55Angiology, University of Bologna, Bologna 66Respiratory Medicine, Catholic University, Rome, Italy
How-to-cite Ageno W, Agnelli G, Imberti D, Moia M, Palareti G, Pistelli R, Rossi R, Verso M. INDIVIDUAL AND CLINICAL PREDICTORS OF THE TIMING OF DIAGNOSIS OF VENOUS THROMBOEMBOLISM: RESULTS FROM THE MASTER REGISTRY. J Thromb Haemost 2007; 5 Supplement 2: P-S-569
Introduction: Substantial delays in the diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) have been reported. We aimed to identify individual and clinical predictors of the timing of diagnosis of venous thromboembolism (VTE).
Methods: MASTER is a multicenter registry of patients with acute VTE. Information on clinical presentation and diagnostic methods, temporary and permanent risk factors, were captured by an electronic data network at the time of the index event in patients with objectively confirmed acute VTE.
Results: Data on 2047 patients (1024 males), 1505 with DVT and 542 with PE, were analysed. Delayed diagnosis (i.e. more than 10 days from onset of symptoms) was observed in 340 (22.6%) patients with DVT and in 88 (16.2%) with PE, respectively (OR for delayed diagnosis PE vs DVT: 0.50; 95% CI 0.41-0.62). In both groups, age or gender were not associated with the timing of diagnosis. In DVT patients, factors associated with earlier diagnosis were the presence of multiple signs or symptoms (p=0.014), the presence of pain (p=0.049), and a history of VTE (p=0.016). Neither the presence of other known risk factors nor ongoing VTE prophylaxis influenced the timing of diagnosis. In PE patients, only multiple signs or symptoms at presentation (p=0.014) and the presence of transient risk factors for VTE (p=0.001) were significantly associated with earlier diagnosis.
Conclusions: Substantial delays occur when diagnosing VTE. The severity of presentation, but not patient risk profile are associated with earlier diagnosis, even in patients with signs or symptoms of PE. The long term follow up of this registry is now aimed to assess whether the timing of diagnosis of VTE is associated with prognosis. The results will be available for the meeting.