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A DIAGNOSTIC TOOL TO SAFELY EXCLUDE DVT IN HIGH RISK GROUPS
Abstract number: P-W-531
Toll1 D.B., Oudega1 R., Hoes1 A.W., Moons1 K.G.M.
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
How-to-cite Toll DB, Oudega R, Hoes AW, Moons KGM. A DIAGNOSTIC TOOL TO SAFELY EXCLUDE DVT IN HIGH RISK GROUPS. J Thromb Haemost 2007; 5 Supplement 2: P-W-531
Abstract
Introduction: Recently a new, simple diagnostic rule was introduced to enable general practitioners to safely refrain from referring a considerable proportion of the patients suspected of having deep venous thrombosis (DVT). The rule (which includes 7 patient history and physical examination items plus the result of a D-dimer test) discriminates "very low" risk patients (not to be referred) from patients with an increased risk of DVT (to be referred). However, the rule's efficiency (proportion of patients designated by the rule as very low risk of DVT) and safety (percentage "missed" DVT cases among these very low risk patients) may change according to patient characteristics. We tested the rule's safety and efficiency across 3 age groups, in men and women, and in patients with and without a history of DVT, separately.
Methods: We retrospectively analyzed data of 2086 primary care patients suspected of DVT, in whom all rule items and the result of the reference ("gold") standard (compression ultrasonography) were collected.
Results: The rule's efficiency decreased with age from 37.1% in the relatively young (<50 years) compared to 9.9% in patients aged >=70 years. The low efficiency in the elderly could be improved without compromising the safety by increasing the D-dimer threshold. The percentage of DVT among the very low risk patients was <1.5% in all subgroups.
Conclusions: Regardless of patient characteristics, the rule can safely exclude DVT in relevant patient subgroups in up to almost 40% of the primary care patients suspected of DVT.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
Session Details
| Date: |
01/08/2007
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| Time: |
00:00-00:00
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| Session name: |
XXIst ISTH Congress |
| Subject: |
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| Location: |
Oxford, UK |
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