J Korean Soc Emerg Med.  2016 Feb;27(1):8-14. 10.0000/jksem.2016.27.1.8.

Do We Have to Check Pulmonary Thromboembolism in Patients with Deep Vein Thrombosis in Emergency Department?

• Kim T
• Ryoo SM
• Ahn S
• Sohn CH
• Seo DW
• Lee JH
• Lee YS
• Lim KS
• Kim WY

• KMID: 2191631
• DOI: http://doi.org/10.0000/jksem.2016.27.1.8

Abstract

PURPOSE
Deep vein thrombosis (DVT) is a risk factor of pulmonary thromboembolism (PTE), however it is not clear who should be evaluated for a PTE and a DVT at the same time. The purpose of this study is to determine the clinical characteristics of PTE in patients with DVT who visited the emergency department (ED).
METHODS
This was a retrospective cohort study of ED patients who visited with DVT and were simultaneously evaluated for a PTE from January 2012 to December 2013. We compared clinical characteristics between non-PTE and PTE patients with confirmed DVT in the ED.
RESULTS
Of these 166 patients, 96 patients (57.8%) were confirmed PTE by computed tomography. In multivariate analysis, patients with PTE had more systemic neoplasm (OR 2.03, 95% CI 1.04-3.93, p=0.037) and right heart strain pattern in electrocardiography (OR 5.29, 95% CI 1.71-16.36, p=0.004) than patients without PTE. Femoral DVT was more likely in the non-PTE group (87.1% vs. 65.6%, p=0.002) and popliteal DVT was more likely in the PTE group (62.9% vs. 80.2%, p=0.013). However the number of DVT sites including both femoral and popliteal vein was not statistically different.
CONCLUSION
In patients with systemic neoplasm or right heart strain patterns in electrocardiography, simultaneous PTE evaluation may be required in patients with DVT.

Keyword

Venous thrombosis; Thromboembolism; Multidetector computed tomography

MeSH Terms

Cohort Studies
Electrocardiography
Emergencies*
Emergency Service, Hospital*
Heart
Humans
Multidetector Computed Tomography
Multivariate Analysis
Popliteal Vein
Pulmonary Embolism*
Retrospective Studies
Risk Factors
Thromboembolism
Venous Thrombosis*