Abstract Number: PB2423
Meeting: ISTH 2020 Congress
Background: Approximately 85% of individuals with suspected deep vein thromboses (DVT) have a DVT excluded. Investigational studies usually include a 90-day follow up on such patients to determine the percentage of false negative results. This outcome measure is not usual in routine clinical practice.
Aims: To evaluate the outcome and potential benefit of including a 90-day follow up in routine clinical practice for patients attending a primary care-based clinic with suspected DVT, who have had a DVT excluded.
Methods: All patients referred to our nurse-led, community hospital DVT assessment service were initially evaluated with a 2-level Wells score and Point of Care quantitative D-dimer (Cardiac D-dimer, Roche). A DVT was excluded if both of these were negative, or if either or both were positive by a negative Compression Ultrasound Scan (CUS) performed as per the NICE (National Institute for Health and Care Excellence) protocol. These patients had a 90-day telephone follow up to ascertain whether they had subsequently developed a DVT or pulmonary embolus or had been treated with an anticoagulant during the follow up period.
Results: Between January and October 2019, 266 patients were seen. Ten were diagnosed with a DVT and 26 with a superficial venous thrombosis. 230 (86.5%) were discharged with DVT excluded and had a 90-day follow up. Only 1 (0.4%) had developed a DVT after 6 weeks, associated with starting chemotherapy for cancer.
Conclusions: Our very low false negative rate on 90-day follow up showed that our nurse-led assessment and CUS results were reliable. This shows good clinical practice, was good for nursing staff morale and encouraging for patients discharged with a DVT excluded. We suggest that a 90-day follow up should be part of routine clinical practice as an important outcome measure in patients in whom a DVT has been excluded.
To cite this abstract in AMA style:Hughes A, Good M, Good K, Piper B, Jennings K, North K, Kawira D, Varghese B, Harwood G. 90-Day Follow up in Patients with Suspected Deep Vein Thromboses (DVT) who Have Had a DVT Excluded: Should this Be Routine Clinical Practice? [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/90-day-follow-up-in-patients-with-suspected-deep-vein-thromboses-dvt-who-have-had-a-dvt-excluded-should-this-be-routine-clinical-practice/. Accessed January 18, 2021.
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