Clinical versus radiological assessment of patients treated for deep vein thrombosis
DOI:
https://doi.org/10.18203/2349-2902.isj20180373Keywords:
Clinical methods, Deep vein thrombosis, DopplerAbstract
Background: Clinical versus radiological assessment of patients treated for deep vein thrombosis. Aims and objectives of this study were to evaluate the patient treated for deep vein thrombosis (DVT) with reference to clinical examination and radiological imaging. To compare the predictive value of clinical methods versus radiological methods in the assessment of recovery of a patient following treatment of DVT. To study the sensitivity and specificity of the clinical and radiological methods used in assessing the effectiveness of treatment of DVT.
Methods: A prospective observational study was conducted on 80 patients of 18-50 years age groups with deep venous thrombosis treated with standard treatment protocol at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune over a period of 2 years. All patients were assessed clinically and radiologically using colour Doppler, post treatment at an interval of 3 months and 6 months.
Results: At the end of 3 months of treatment, to detect complete recovery, the clinical assessment was found to have a lower sensitivity (56.25%) and specificity (81.25%) on comparison with radiological assessment. At the end of 6 months of treatment, to detect complete recovery, the clinical assessment was found to have a relatively better sensitivity (100%) but lower specificity (65.31%) on comparison with radiological assessment when compared to assessment after 3 months of treatment.
Conclusions: The study has suggested that clinical assessment of patients after treatment of DVT has a varied value as far as complimenting radiological assessment of the same series of patients is concerned. When assessing patients after 3 months of treatment, clinical methods were found to be far inferior to radiological methods while after 6 months of treatment they were found to be on par with radiological methods. Hence, clinical methods can be used along with radiological methods for assessment, but radiological methods remain gold standard.
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References
Kapoor VK. Venous Thromboembolism in India. National Med J India. 2010;23(4):193-5.
Hanley M, Donahue J, Rybicki FJ, Dill KE, Bandyk DF, Francois CJ, et al. ACR Appropriateness Criteria: Suspected Lower-Extremity DVT. 2013;1-6.
Hirsch J, Hull RD, Raskob GE. Clinical Features and Diagnosis of Venous Thrombosis. Journal of Am Col Cardiol. 1986;8:1l4B-27B.
O'Donnell TF, Abbott WM, Athanasoulis CA, Millan VG, Callow AD. Diagnosis of deep venous thrombosis in the outpatient by venography. Surg Gynecol Obstet. 1980;150(1):69-74.
Goodacre S, Sampson F, Thomas S, van Beek E, Sutton A. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC Med Imaging. 2005;5:6.
Lensing AW, Prandoni P, Brandjes D, Huisman PM, Vigo M, Tomasella G, et al. Detection of deep-vein thrombosis by real-time B-mode ultrasonography. New England J Med. 1989;320:342-5.
Schwarz T, Schmidt B, Schmidt B, Schellong SM. Interobserver agreement of complete compression ultrasound for clinically suspected deep vein thrombosis. Clin App Thrombos/Haemost. 2002;8:45-9.
Kraaijenhagen RA, Lensing AW, Wallis JW, van Beek EJ, ten Cate JW, Büller HR. Diagnostic management of venous thromboembolism. Baillière's Clin Haematol. 1998;11(3):541-86.