Key result
Proximal DVT, prior PE, obesity, chronic lung disease, and omission of prophylaxis emerged as independent predictors of concomitant symptomatic PE in patients with DVT.
Why the study?
What are the independent predictors of concomitant symptomatic pulmonary embolism in patients with deep vein thrombosis?
Cohort (n=4,211)
What are the independent predictors of concomitant symptomatic pulmonary embolism in patients with deep vein thrombosis?
Proximal DVT, prior PE, obesity, chronic lung disease, and lack of prophylaxis are independent predictors of concomitant symptomatic PE in patients presenting with DVT.
Answers are grounded in this paper and cite their sources.
May inform risk stratification for concomitant PE in DVT; leaves open whether targeting these factors improves outcomes.
In patients with deep vein thrombosis (DVT), the factors which predispose to concomitant symptomatic pulmonary embolism (PE) have remained uncertain. From a prospective cohort of 5,451 consecutive patients with ultrasound-confirmed DVT, we analyzed 4,211 patients with a known status for presence (n=639) or absence (n=3572) of symptomatic PE. Age and gender were similar in DVT plus PE (63.7+/-15.6 years; 49% men) and DVT patients (63.4+/-17.3 years; 46% men). Body mass index (BMI) was higher in patients with DVT plus PE (median 29.0, range 15.4-67.0 kg/m2) than in patients with DVT (median 26.8, range 9.7-64.4 kg/m2; p<0.001). Chronic lung disease (17% vs. 12%; p<0.001), a personal history of PE (11% vs. 6%; p<0.001), and a family history of DVT or PE (8% vs. 4%; p<0.001) were more frequent in DVT plus PE patients. Twenty-seven percent of DVT plus PE patients received prophylaxis prior to the thromboembolic event compared with 32% of DVT patients (p=0.002). Proximal DVT (OR 1.84, 95% CI 1.39-2.43), prior PE (OR 1.68, 95% CI 1.20-2.35), obesity (BMI >30 kg/m2) (OR 1.65, 95% CI 1.33-2.04), chronic lung disease (OR 1.51, 95% CI 1.13-2.01), as well as omission of prophylaxis (OR 1.30, 95% CI 1.04-1.64) emerged as independent predictors of concomitant symptomatic PE.
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Kucher et al. (2005) conducted a cohort in Deep vein thrombosis (n=4,211). Proximal DVT vs. Absence of proximal DVT was evaluated on Concomitant symptomatic pulmonary embolism (OR 1.84, 95% CI 1.39-2.43). Proximal DVT, prior PE, obesity, chronic lung disease, and omission of prophylaxis emerged as independent predictors of concomitant symptomatic PE in patients with DVT.
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