Testing Clinical Scores to Diagnose Incident Deep Vein Thrombosis in Patients Hospitalized in a Department of Medicine: Can Biomarkers Improve Accuracy?

Shifting the context from the emergency department to the department of medicine, we compared different scores to diagnose deep vein thrombosis (DVT) in patients with several comorbidities, hospitalized in a department of internal medicine. We prospectively recruited 178 consecutive hospitalized pat...

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Bibliographic Details
Published in:Angiology 2016-03, Vol.67 (3), p.245-251
Main Authors: Malatino, Lorenzo, Cardella, Antonella M., Puccia, Giuseppe, Cilia, Chiara, Terranova, Valentina, Cataudella, Emanuela, Buonacera, Agata, Tripepi, Giovanni, Di Marca, Salvatore, Mastrosimone, Gianluca, Pisano, Marcella, Giordano, Mauro, Stancanelli, Benedetta
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Area Under Curve
Biomarkers - blood
Comorbidity
Decision Support Techniques
Female
Hospital Departments
Hospitalization
Humans
Incidence
Italy - epidemiology
Male
Middle Aged
Phlebography - methods
Predictive Value of Tests
Prospective Studies
Protein S - analysis
Reproducibility of Results
Risk Factors
ROC Curve
Serum Albumin - analysis
Serum Albumin, Human
Tomography, X-Ray Computed
Ultrasonography, Doppler, Color
Venous Thrombosis - blood
Venous Thrombosis - diagnosis
Venous Thrombosis - epidemiology
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Description
Summary:Shifting the context from the emergency department to the department of medicine, we compared different scores to diagnose deep vein thrombosis (DVT) in patients with several comorbidities, hospitalized in a department of internal medicine. We prospectively recruited 178 consecutive hospitalized patients in whom clinical suspicion of DVT was assessed by Wells modified score for DVT, Hamilton, Kahn, and St Andrè Hospital scores. Deep vein thrombosis was confirmed in 85 (48%) patients by both echocolor Doppler and angiocomputed tomography scan. The use of risk scores based on symptoms and clinical signs was weakly useful (area under the curve [AUC]: 0.69, positive predictive value: 59%, and negative predictive value: 74%). Patients with DVT had significantly (P < .0001) lower serum albumin and protein S levels compared to those without DVT. Moreover, serum protein S (AUC: 0.82) and albumin in percentage (AUC: 0.80) showed a better accuracy than clinical scores (P < .001) in assessing the diagnosis of DVT. Therefore, serum albumin and protein S improved the accuracy of clinical scores for the diagnosis of incident DVT in patients hospitalized in a department of medicine.
ISSN:0003-3197
1940-1574
DOI:10.1177/0003319715586289