Pulmonary Embolism Risk Assessment in Acute Isolated Distal Deep Venous Thrombosis.

Jingqiu Zhang, Jin Wang, Yongping Lu
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Abstract

The clinical risk factors and risk of developing pulmonary embolism (PE) in patients with acute isolated distal deep venous thrombosis (IDDVT) were assessed using single complete-duplex ultrasound (CDUS) imaging to reduce over-testing and over-treatment. This observational study was conducted from January 2020 to December 2022. Retrospective analysis was performed on CT pulmonary angiography (CTPA), blood coagulation markers, myocardial injury markers, blood gas analysis, and CDUS imaging of the lower extremity blood vessels of 146 patients with newly diagnosed IDDVT. Binary logistic regression was used to evaluate the relationship between these indicators and PE. After stepwise regression analysis, the predictors included in the regression model were D-dimer (DD), the sum of the thrombus length, and the maximum value of the thrombus width, with odds ratios (ORs) of 1.307 (p <0.001), 1.018 (p = 0.005), and 1.613 (p = 0.018), respectively. The combined prediction model achieved an area under the receiver operating characteristic curve (AUC) of 0.832 [95% confidence interval (CI): 0.761, 0.902]. By balancing the sensitivity and specificity of DD, combined single CDUS improves the predictive value for PE in patients with IDDVT. Key Words: Venous thrombosis, Pulmonary embolism, Ultrasonography, D-dimer, Diagnosis.

急性孤立远端深静脉血栓形成的肺栓塞风险评估。
使用单次全双工超声(CDUS)成像评估急性孤立远端深静脉血栓形成(IDDVT)患者的临床风险因素和发生肺栓塞(PE)的风险,以减少过度检测和过度治疗。这项观察性研究于 2020 年 1 月至 2022 年 12 月进行。对146名新确诊的IDDVT患者的CT肺血管造影(CTPA)、血液凝固标志物、心肌损伤标志物、血气分析和下肢血管CDUS成像进行了回顾性分析。采用二元逻辑回归评估这些指标与 PE 之间的关系。经过逐步回归分析,纳入回归模型的预测因子为 D-二聚体(DD)、血栓长度总和和血栓宽度最大值,其几率比(OR)为 1.307(P<0.05)。
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