RT Journal
A1 Huisman MV, Büller HR, ten Cate JW, Heijermans HF, van der Laan J, van Maanen DJ
T1 MAnagement of clinically suspected acute venous thrombosis in outpatients with serial impedance plethysmography in a community hospital setting
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1989
FD March 1
VO 149
IS 3
SP 511
OP 513
DO 10.1001/archinte.1989.00390030017004
UL http://dx.doi.org/10.1001/archinte.1989.00390030017004
AB • The reported high sensitivity and specificity of impedance plethysmography (IPG) in the diagnosis of proximal vein thrombosis were evaluated in a prospective cohort follow-up study, in which IPG was performed three times over a period of seven days in 243 consecutive outpatients with clinically suspected deep venous thrombosis (DVT). The test was abnormal in 112 patients (46%). The positive predictive value of an abnormal IPG for venography-proved DVT was 90%. One hundred thirty-one patients (54%) with repeatedly normal tests were considered not to have DVT, and anticoagulants were withheld. During six months of follow-up, completed in all patients with repeatedly normal IPG, no patient died of venous thromboembolism and no patient returned with clinically suspected pulmonary embolism. One patient (0.8%) returned after two months with recurrent leg symptoms, and venous thrombosis was documented (95% confidence limits, 0.02% to 4.21%). Another patient, who was nonsymptomatic, had an abnormal IPG at the three-month follow-up visit, and venography revealed venous thrombosis. Patients sent by general practitioners to a community hospital, with clinically suspected acute DVT, can be effectively managed by serial IPG alone.(Arch Intern Med 1989;149:511-513)