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Characterization and probability of upper extremity deep venous thrombosis
Zachary C Schmittling1, Robert B McLafferty, W Todd Bohannon
1Department of Surgery, Division of Vascular Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
Annals of Vascular Surgery
|November 10, 2004
Summary
This study developed a diagnostic model for upper extremity deep venous thrombosis (UEDVT) using risk factors like limb tenderness and central venous catheterization. The model aids in timely diagnosis and treatment of UEDVT.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Epidemiology
Background:
- Upper extremity deep venous thrombosis (UEDVT) is a significant clinical concern.
- Accurate diagnosis and risk stratification are crucial for effective management.
- Previous studies have varied in their focus on risk factors and anatomical distribution.
Purpose of the Study:
- To characterize patient demographics, risk factors, and anatomical distribution of UEDVT.
- To develop a predictive probability model for UEDVT diagnosis.
- To improve the utilization of color-flow duplex scanning (CDS) and guide timely anticoagulation therapy.
Main Methods:
- Retrospective review of 177 patients undergoing CDS for suspected acute UEDVT over a 5-year period.
- Evaluation of patient risk factors and clinical symptoms as predictors of UEDVT.
- Multivariate analysis to identify significant positive and negative predictors.
Main Results:
- Acute UEDVT was diagnosed in 30% of cases (40% with deep system involvement).
- Commonly involved veins included subclavian (64%), axillary (25%), and internal jugular (32%).
- Positive predictors: limb tenderness (OR 9.3), central venous catheterization (OR 7.0), malignancy (OR 2.9). Negative predictors: erythema (OR 0.12), suspected pulmonary embolism (OR 0.06).
Conclusions:
- A predictive model for UEDVT was successfully designed using identified risk factors.
- This model can enhance clinical suspicion and optimize CDS use.
- Timely anticoagulation treatment can be facilitated by this diagnostic approach.