Approach to Leg Edema of Unclear Etiology

Ely, John; Osheroff, Jerome A.; Chambliss, M. Lee; Ebell, Mark H.

doi:10.3122/jabfm.19.2.148

Cited by 159 publications

(111 citation statements)

References 61 publications

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“…In the present study, age >65 years, presence of limb swelling, pain, cancer, and clinical suspicion of PEwere independent major risk factors for the presence of DVT and should therefore be taken into 14,16 .In our sample of patients with a clinical suspicion of DVT, limb swelling was the sign/ symptom most commonly observed: 68% of the patients had this complaint, and DVT was more frequent in these patients. Pain was the second most frequent symptom.…”

Section: Discussionmentioning

confidence: 87%

Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound

Baroncini¹,

França²,

Oliveira³

et al. 2013

J. vasc. bras.

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Background: Symptoms and clinical signs suggestive of deep vein thrombosis (DVT) are common but may have numerous possible causes. Objectives: 1) To identify the most frequent clinical symptoms and correlate them with duplex ultrasound scan (DS) findings; 2) to identify high-risk clinical conditions for DVT; and 3) to evaluate time since the onset of symptoms and DS examination. Methods: A total of 528 patients with a clinical suspicion of DVT were evaluated by DS performed by experienced vascular ultrasonographists. Results: DVT was present in 192 (36.4%) of the patients. The external iliac vein was involved in 53 patients (10.04%), the femoral veins in 110 (20.83%), the popliteal vein in 124 (23.48%), and veins below the knee were involved in 157 (29.73%) of the cases. Limb swelling was present in 359 cases (68%), and 303 (57.4%) complained of pain. Sixty nine patients received a DS due to suspected or proven pulmonary embolism (PE); 79 patients were in postoperative period. In the multivariate analysis, independent risk factors for DVT included age>65 years (OR=1.49; 95% confidence interval [95%CI] 1.01-2.18; p=0.042), edema (OR=2.83; 95%CI 1.72-4.65; p<0.001), pain (OR=1.99; 95%CI 1.3-3.05; p=0.002), cancer (OR=2.32; 95%CI 1. p<0.001), and PE (OR=2.62; p=0.008).Time since the onset of symptoms did not differ between the groups. Conclusions: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT.

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Section: Discussionmentioning

confidence: 87%

Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound

Baroncini¹,

França²,

Oliveira³

et al. 2013

J. vasc. bras.

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“…Это связа-но с тем, что в возрасте старше 50 лет хроническая венозная недостаточность выявляется у 30% населе-ния, а сердечная недостаточность у 1%. идиопати-ческий отек нижних конечностей чаще выявляется у женщин младше 50 лет [3].…”

Section: тромбоз глубоких венunclassified

“…дополнительным критерием идиопатического отека является повышение массы тела перед сном по срав-нению с ранним утром 0,7 кг. учитывая, что наиболее вероятным механизмом отека является вторичный гиперальдостеронизм, препаратом выбора является спиронолактон [3].…”

Section: дополнительные методы исследованияunclassified

Peripheral edema: diagnostics and treatment

Zhuravlyova¹,

Yankevich²

2014

Shidnoevr. z. vnutr. simejnoi med.

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Схiдноєвропейський журнал внутрiшньої та сiмейної медицини, 2014, № 1 15Питання диференційної діагностики. симПозіум Доказова практика профілактики серцево-судинної патології Проф. О.М. Корж, доц. Г.І. Кочуєв, доц. С.В. Краснокутський Харківська медична академія післядипломної освіти, Україна В даній роботі розглядаються з позицій доказової медицини принципи ведення пацієнтів високого серцево-судинного ризику. У пацієнтів з декількома факторами ризику недостатнім є вплив на кожен фактор окремо, необхідний заснований на доказових принципах інтегрований спрямований підхід. Для забезпечення ефективності такого підходу, потрібно підсумовувати і обговорити докази, на яких він ґрунтується. Розглянуто можливості підвищення мотивації лікарів і пацієнтів в зниженні серцево-судинного ризику.Ключові слова: високий серцево-судинний ризик, доказова медицина, терапевтичні підходи. This paper deals with the position of evidence-based medicine principles of management of patients at high cardiovascular risk. In patients with multiple risk factors is insufficient impact on each factor separately, is required based on the principles of evidence-based integrated approach aimed. To ensure the effectiveness of this approach, it is necessary to summarize and discuss the evidence on which it is based. The possibilities of increasing the motivation of doctors and patients in reducing cardiovascular risk. Evidence

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“…Patients with peripheral vascular disease have an high risk for skin and soft tissue infections because the impaired vascular supply to extremities and peripheral edema (Sieggreen MY & Kline RA, 2004;Ely JW & Al;2006). Patients with chronic obstructive pulmonary disease are likely to have bacterial colonization of tracheobronchial tree and recurrent bronchopulmonary infections (Marin A & Al, 2010).…”

Section: Chronic Diseases and Comorbilitymentioning

confidence: 99%