Venous thromboembolism in the emergency department – single-center experience

Abstract

Given the importance of early recognition of acute venous thromboembolism (VTE ) and the nonspecificity of its symptoms and signs, it is essential to follow the guidelines for diagnostic and therapeutic decisions. Ultrasound examination of the entire lower extremity is currently the standard diagnostic method for symptomatic patients with a clinical probability of deep vein thrombosis (DVT) according to the Wells scoring system. The aim of this study is to show the demographic structure and analyze the number of patients in the emergency department with suspected venous thrombosis. In the past 10 years, 2,022 patients with DVT and 686 with pulmonary emboli have been diagnosed. Despite adherence to the diagnostic protocol, nearly two-thirds of patients require early ultrasound diagnosis. One-fifth of patients had thrombosis of the superficial venous system of the leg or arm. Thrombus was present in the veins of the lower leg in 37% of patients with DVT. The presence of thrombi above the knee, involving the deep femoropopliteal venous system, was found in as much as one-third of patients. These findings and current guidelines suggest that there is a paradigm shift toward more frequent use of DO AC in patients with DVT. However, greater educational efforts may be needed for many physicians to become comfortable with the use of DO AC in the outpatient management of patient populations at low risk for pulmonary embolism.

Keywords

• venous thrombosis
• pulmonary embolism
• venotromboembolism
• emergency medicine