At The Primary Care Level Rule Out Deep Vein Thrombosis

At the primary level of patient care, algorithms improve certainty in ruling out deep and pelvic vein thrombosis.

This was said by Lobna El Tabei and her co-authors in the current issue of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2012; 109[45]: 761-6).

Deep Vein Thrombosis (DVT) - Causes - Symptoms - Diagnosis - Treatment - Complications - Prevention
A blood clot (thrombus) in the deep venous system of the leg leads to deep vein thrombosis (DVT). DVT is a major cause of morbidity and mortality.

Deep vein thrombosis (DVT) can lead to fatal pulmonary embolism or chronic post-thrombotic syndrome. To improve differential diagnostic certainty, scores have been developed that allow the clinical probability of DVT to be calculated on the basis of weighted combinations of individual clinical findings. Items of these scores are, for example, cancer, paresis of the leg, extended periods of bed rest, swelling, and pain.

The primary aim of the study was to determine diagnostic accuracy regarding exclusion of DVT using a treatment algorithm consisting of one of these scores, the Wells score, followed by either a D-dimer test and/or compression sonography—depending on the result of the Wells score—and to compare this with the diagnostic accuracy of the primary care physician's clinical judgment alone.

The algorithm investigated by the authors allows the primary care physician to rule out DVT with a high degree of probability. In this study, which included 395 patients, only 1% of cases of DVT were missed, compared with 5% when relying on clinical judgment alone.

Deep Vein Thrombosis and Flying - Symptoms - Diagnosis - Treatment - Precautions
WHO sponsored Research Into Global Hazards of Travel (WRIGHT) Project has discovered that the DVT risks approximately doubles after a long-distance flight.

Source-Eurekalert

Pulmonary Embolism and Deep Vein Thrombosis / Venous Thromboembolism
Deep vein thrombosis (DVT) is a condition where blood clots develop usually in the deep veins of the legs. Pulmonary embolism (PE) occurs when these clots break away and block the pulmonary artery.

Research Indicates Deep Vein Thrombosis is More Likely to Occur on the Left Side of Pregnant Women
A review in CMAJ (Canadian Medical Association Journal says that deep vein thrombosis in pregnant patients is more likely to occur on the left side, and in particular in the left leg.