Prospective comparison of emergency physician–performed venous ultrasound and CT venography for deep venous thrombosis

Shiver, Stephen A.; Lyon, Matthew; Blaivas, Michael; Adhikari, Srikar

doi:10.1016/j.ajem.2009.01.009

Cited by 33 publications

(33 citation statements)

References 23 publications

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“…Studies into abbreviated US performed by EPs for proximal LEDVT have found sensitivities and specificities ranging from 70% to 100% and from 41.2% to 100%, respectively . Reported 95% CIs for both parameters often occupy spans of 20% or more.…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta‐analysis suggests US performed by EPs for LEDVT has weighted mean sensitivity of 96.1% (95% confidence interval [CI]: 90.6–98.5%) and specificity of 96.8% (95% CI: 94.6–98.1%); however, this pooled studies with significantly heterogeneous methodologies, including an investigation of full‐leg US . Abbreviated US performed by EPs for proximal LEDVT has been evaluated in 10 published articles . Estimates for sensitivity and specificity are inconsistent and imprecise .…”

Section: Introductionmentioning

confidence: 99%

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Sensitivity and specificity of three‐point compression ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis

Crowhurst

Dunn

2013

Emerg Medicine Australasia

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sensitivity and specificity of three‐point compression ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis

Crowhurst

Dunn

2013

Emerg Medicine Australasia

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“…Either Doppler or duplex ultrasound screening have been used as the gold standard in major studies 11, 12, 14. Although ultrasound can be carried out at the bedside non‐invasively without contrast material, the diagnostic accuracy is extremely sensitive to the experience of the examiner 19. Also, associated injuries often limit the complete screening, which possibly leads to poor accuracy in the detection of DVT 20.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism in major trauma patients: a single‐center retrospective cohort study of the epidemiology and utility of D‐dimer for screening

Yumoto

Naito

Yamakawa

et al. 2017

Acute Medicine & Surgery

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AimVenous thromboembolism (VTE) can be a life‐threatening complication after major trauma. The aim of this study was to investigate the epidemiology of VTE and to assess the usefulness of D‐dimer for screening for VTE in major trauma cases among the Japanese population.MethodsWe examined a single‐center retrospective cohort of severely injured trauma patients who had been admitted to the emergency intensive care unit at Okayama University Hospital (Okayama, Japan) from April 2013 through to March 2016. Venous thromboembolism was confirmed by computed tomography angiography and computed tomography venography, which was determined based on the attending physician monitoring daily D‐dimer levels. Independent risk factors for VTE were determined by multiple logistic regression analysis. D‐dimer levels were evaluated using area under the receiver operating characteristic curve (AUROC) to predict VTE.ResultsThe study cohort consisted of 204 trauma patients (median Injury Severity Score, 20). Of the 204 patients, 65 (32%) developed VTE. The median time from admission to VTE diagnosis was 10 days. In multiple logistic regression analysis, higher Injury Severity Score and the presence of lower extremity fractures were revealed to be a risk factor for VTE. D‐dimer levels at day 10 showed moderate accuracy, of which the AUROC was 0.785 (95% confidence interval, 0.704–0.866; P < 0.001). The cut‐off that maximized the Youden index was 12.45 μg/mL.ConclusionsAt least one of every three major trauma patients had potential development of VTE at a median of 10 days following admission to the intensive care unit. D‐dimer levels on day 10 can be a useful predictor of VTE.

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“…4,6 Third, several studies included patients with distal or iliac thrombosis, which emergency physician-performed ultrasonography is not designed to detect. [6][7][8][9] In summary, this meta-analysis supports emergency physicianperformed ultrasonography by welltrained physicians to diagnose deep venous thrombosis in patients without technically difficult examinations. The majority of the examinations in these studies were performed by physicians with interest or additional training in ultrasonography.…”

Section: Data Extraction and Synthesismentioning

confidence: 93%

What Is the Accuracy of Emergency Physician–Performed Ultrasonography for Deep Venous Thrombosis?

West

Shannon

Chilstrom

2015

Annals of Emergency Medicine

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Prospective comparison of emergency physician–performed venous ultrasound and CT venography for deep venous thrombosis

Cited by 33 publications

References 23 publications

Sensitivity and specificity of three‐point compression ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis

Sensitivity and specificity of three‐point compression ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis

Venous thromboembolism in major trauma patients: a single‐center retrospective cohort study of the epidemiology and utility of D‐dimer for screening

What Is the Accuracy of Emergency Physician–Performed Ultrasonography for Deep Venous Thrombosis?

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