Deep Vein Thrombosis as a Harbinger of Malignancy in the Emergency Department.

Objective: To determine whether malignancy was discovered within one year of follow-up in patients with deep vein thrombosis (DVT) in the emergency department (ED).

Study design: Descriptive study. Place and Duration of the Study: Department of Emergency Medicine, School of Medicine, Duzce University, Duzce, Turkiye, from November 2019 to November 2022.

Methodology: All patients diagnosed with lower limb DVT on venous Doppler ultrasound were included in this study. Patients with a confirmed diagnosis or suspicion of malignancy were excluded. The study outcome was the discovery of malignancy within a year. DVT patients subsequently diagnosed with malignancy were grouped as secondary or idiopathic.

Results: A total of 224 DVT patients without malignancy were studied. The median age of patients diagnosed with DVT was 65.5 years (47-77), of which, 51.8% were females. Malignancy was detected in 5.4% (12/224) of the patients within one year. Malignancy discovery was significantly higher in the secondary DVT group (OR = 4.52, 95% CI = 1.31-11.55; p = 0.021). Ten of 12 patients (83.3%) diagnosed with malignancy were from the genitourinary or gastrointestinal systems.

Conclusion: In patients without known malignancy who were diagnosed with DVT in the ED, the rate of malignancy discovery in a one-year follow-up was 5.4%. EDs, where DVT is frequently diagnosed, are a hub of opportunities for early detection of malignancy. Arranging primary care follow-up of patients with DVT will contribute to better early diagnosis and survival rates, especially for genitourinary and gastrointestinal malignancies.

Key words: Deep vein thrombosis, Malignancy, Emergency department, Venous Doppler ultrasound.