Key result
Serum protein S (AUC 0.82) and albumin (AUC 0.80) demonstrated better diagnostic accuracy than clinical scores (AUC 0.69) for incident DVT in hospitalized patients (P<.001).
Why the study?
Do clinical scores and biomarkers accurately diagnose incident DVT in hospitalized internal medicine patients?
Observational (n=178)
Do clinical scores and biomarkers accurately diagnose incident DVT in hospitalized internal medicine patients?
p-value: p=<.001
Serum albumin and protein S levels provide better diagnostic accuracy for incident DVT than standard clinical scores in hospitalized internal medicine patients.
May support biomarker-aided DVT detection in hospitalized patients; hypothesis-generating and requires prospective validation before practice change.
Shifting the context from the emergency department to the department of medicine, we compared different scores to diagnose deep vein thrombosis (DVT) in patients with several comorbidities, hospitalized in a department of internal medicine. We prospectively recruited 178 consecutive hospitalized patients in whom clinical suspicion of DVT was assessed by Wells modified score for DVT, Hamilton, Kahn, and St Andrè Hospital scores. Deep vein thrombosis was confirmed in 85 (48%) patients by both echocolor Doppler and angiocomputed tomography scan. The use of risk scores based on symptoms and clinical signs was weakly useful (area under the curve [AUC]: 0.69, positive predictive value: 59%, and negative predictive value: 74%). Patients with DVT had significantly (P < .0001) lower serum albumin and protein S levels compared to those without DVT. Moreover, serum protein S (AUC: 0.82) and albumin in percentage (AUC: 0.80) showed a better accuracy than clinical scores (P < .001) in assessing the diagnosis of DVT. Therefore, serum albumin and protein S improved the accuracy of clinical scores for the diagnosis of incident DVT in patients hospitalized in a department of medicine.
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Malatino et al. (2015) conducted an observational in Deep vein thrombosis (n=178). Serum albumin and protein S levels vs. Clinical scores (Wells modified, Hamilton, Kahn, St Andrè Hospital) was evaluated on Diagnosis of DVT (p=<.001). Serum protein S (AUC 0.82) and albumin (AUC 0.80) demonstrated better diagnostic accuracy than clinical scores (AUC 0.69) for incident DVT in hospitalized patients (P<.001).
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