The Impact of Duplex Scanning for the Diagnosis of Deep Vein Thrombosis on Workload in a District General Hospital

Abstract

Objective: To assess the impact of changing from ascending phlebography to colour flow duplex (CFD) scanning for the investigation of deep vein thrombosis (DVT) in a District General Hospital and to determine the role of light reflection rheology (LRR) as a Preliminary screening tool for DVT. Design: Retrospective audit. Setting: Vascular Laboratory and Department of Radiology of the Countess of Chester Hospital, Chester, UK. Patients and methods: Audit and review of the all venograms done during the years 1989 to 1991 was undertaken. All the LRR and CFD scans done from 1991 (year of introduction in this hospital) to 1996 were audited and analysed. Outcome measures: Total number of various investigations done for suspected DVT in this hospital from 1989 to 1996 and their detailed analysis. Results: Four hundred and ninety-four venograms were performed between 1989 and 1991, of which 44% confirmed DVT. The least number of venograms was performed in 1991 ( n = 127), after the introduction of LRR. From 1991 through to 1996, the number of LRR scans increased from 90 to 697 and the CFD scans increased from 97 to 786. Conclusion: The audit revealed a 6-fold increase in demand for the examination of limbs for suspected DVT after the introduction of non-invasive tests. LRR continues to be a useful screening tool, reducing the number of CFD scans by 23%.