Managing suspected venous thromboembolism in a mixed primary and secondary care setting using standard clinical assessment and D-dimer in a noninvasive diagnostic strategy

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
M R D de BastosS M Rezende

Abstract

Venous thromboembolism is a potentially lethal disease if not properly treated. Noninvasive strategies have become an attractive clinical option for effective diagnosis. There has been controversy, however, regarding the use of standard clinical rules in a primary care setting. The objective of the present study was to validate a noninvasive diagnostic strategy in an emergency unit giving assistance to patients with primary and secondary care needs. A total of 291 outpatients (primary and secondary care needs) with suspected venous thromboembolism attending the emergency unit of a general hospital from August 2002 to 2004 were retrospectively evaluated. The diagnostic strategy included assessment of risk for venous thromboembolism and a rapid quantitative enzyme-linked immunosorbent assay D-dimer test. Venous thromboembolism was ruled out in patients with a low-probability or intermediate-probability risk (or an unlikely diagnosis) and a negative D-dimer. The prevalence of venous thromboembolism was 8.2%. Patients with an unlikely diagnosis comprised 93.8% of the evaluations for deep venous thrombosis, and those with a low probability for pulmonary embolism comprised 81.4%. Proportions of patients with venous thromboembolic eve...Continue Reading

References

Jul 1, 1996·Annals of Internal Medicine·P PrandoniM H Prins
Mar 11, 1998·BMJ : British Medical Journal·I R Robertson-Steel
Mar 13, 1999·Annals of Internal Medicine·A C JusticeJ A Berlin
Sep 24, 1999·JAMA : the Journal of the American Medical Association·J G LijmerP M Bossuyt
Jan 7, 2000·Family Practice·A T SteinL C Rodrigues
Jun 29, 2000·JAMA : the Journal of the American Medical Association·T G McGinnW S Richardson
Apr 20, 2002·Blood·Jack Hirsh, Agnes Y Y Lee
Apr 23, 2002·Archives of Internal Medicine·Roderik A KraaijenhagenHarry R Büller
Jun 5, 2002·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·G Patrick ShieldsRichard H White
Jun 18, 2003·Annals of Internal Medicine·Marieke J H A KruipHarry R Büller
Sep 26, 2003·The New England Journal of Medicine·Philip S WellsMichael J Kovacs
Dec 17, 2003·British Journal of Haematology·David M KeelingUNKNOWN Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology
Apr 20, 2004·Lancet·Samuel Z Goldhaber
Apr 21, 2004·Annals of Internal Medicine·Paul D SteinNeeraj K Kalra
Jan 1, 1950·Cancer·W J YOUDEN
Jan 27, 2005·Journal of Thrombosis and Haemostasis : JTH·C-E Dempfle
Mar 10, 2005·British Journal of Haematology·Chris GardinerIan J Mackie
Apr 29, 2005·The New England Journal of Medicine·Samuel Z Goldhaber
Jul 20, 2005·Annals of Internal Medicine·Ruud OudegaKarel G M Moons
Jul 20, 2005·Annals of Internal Medicine·Steve GoodacreFiona C Sampson
Jan 13, 2006·JAMA : the Journal of the American Medical Association·Arne van BelleUNKNOWN Christopher Study Investigators
Jan 13, 2006·JAMA : the Journal of the American Medical Association·Philip S WellsHuyen Tran
Sep 12, 2006·Journal of Thrombosis and Haemostasis : JTH·M de BastosS M Rezende

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Citations

Mar 11, 2011·Revista da Associação Médica Brasileira·Marcos de BastosSuely Meireles Rezende
Aug 18, 2009·The American Journal of Emergency Medicine·Oner MentesTurgut Tufan
Nov 10, 2015·Advances in Preventive Medicine·Jina TantonMzwandile Mabhala
Jan 13, 2016·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Márcio Vinícius Lins de BarrosMarcos de Bastos
Aug 6, 2016·The Cochrane Database of Systematic Reviews·Fay CrawfordFrancesca M Chappell
Mar 13, 2012·Biomedical Materials·Alexander Tadeu SverzutAdalberto Luiz Rosa

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