Given these changes, the study reviewed the frequency of lower-extremity DVT among consecutive patients admitted to a university-based freestanding rehabilitation facility. Recently, however, the patient population in the inpatient rehabilitation hospitals has changed, and new prophylactic medications have been introduced. Guidelines for the prophylaxis of hospitalized patients have informed patient's care for years. There are few studies examining the prevalence of occult DVT on admission to acute IRF and the effect of this screening. Despite this risk, it is not the standard of care to screen patients for DVT on admission to an inpatient rehabilitation facility (IRF). Introduction and Background: Early detection and treatment of deep venous thrombosis (DVT) can decrease the morbidity of postthrombotic syndrome as well as the mortality and morbidity resulting from pulmonary embolism. Cases that are inconclusive, or cases in which clinical findings are in evident contradiction to Doppler findings, should undergo duplex examination or venography. ![]() In conclusion, continuous-wave Doppler is accurate and may be used as the initial technique in the diagnosis of DVT. The study was inconclusive in 11 patients. In patients without DVT (n=57), trauma, malignant obstructing tumors, and cellulitis were the most frequent final diagnoses. Prolonged bed rest, previous surgery, and previous DVT were the most frequent risk factors, pain and swelling the most frequent symptoms, and edema and tenderness the main clinical signs. In the entire group of patients with a Doppler ultrasound examination (n=116), 48 cases had a positive study. When a similar analysis was done for the proximal named veins, continuous-wave Doppler examination showed a very high specificity and positive predictive value and a moderate sensitivity and negative predictive value. When cases with an inconclusive result were excluded, Doppler ultrasound showed a sensitivity of 89%, a specificity of 100%, and an accuracy of 94% for the diagnosis of DVT when compared with venography. There were 57 men and 59 women, and from this group a total of 40 patients underwent both Doppler ultrasound examination and venography in the course of forty-eight consecutive hours. Their mean age was fifty-five years (range: eighteen to eighty-eight). Doppler examination was blinded to venography results.Ī total of 116 patients with clinical suspicion of DVT were examined by Doppler ultrasound. In addition, the patients underwent a questionnaire regarding risk factors, symptoms, and mean relevant physical findings. Each case was diagnosed as positive, negative, or inconclusive. To test the effectiveness of this technique the authors prospectively studied patients with clinical suspicion of DVT by Doppler ultrasound and compared the results with those from venography.ĭuring fourteen consecutive months, patients with a clinical suspicion of DVT underwent continuous-wave Doppler examination of both inferior limbs. Continuous-wave Doppler, a precursor noninvasive technique, is simple, cheap, and easy to perform at the patient's bedside. New noninvasive techniques such as B-mode scanning and Doppler ultrasonography (duplex) are highly accurate in the diagnosis of this problem but are relatively expensive and time consuming. ![]() Deep vein thrombosis (DVT) has known morbidity and mortality.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |