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Jornal Vascular Brasileiro

Print version ISSN 1677-5449On-line version ISSN 1677-7301


FORTES, Veronica Barreto et al. Evaluation of a clinical prediction model by Wells et al. in the diagnosis of deep venous thrombosis of the lower limbs. J. vasc. bras. [online]. 2007, vol.6, n.1, pp.7-16. ISSN 1677-5449.

BACKGROUND: The application of a diagnostic strategy based on a clinical model associated with duplex scanning (DS) may allow for a safer and more effective/cost-effective diagnosis of deep venous thrombosis (DVT). OBJECTIVE: To evaluate the clinical model proposed by Wells et al. associated with DS and verify the occurrence of DVT in patients divided into probability of presenting the disease, and assess the possibility of reducing the number of repeated DS based on the results obtained. METHODS: Suspected DVT patients were accordingly categorized into groups of low, moderate and high DVT probability (LP, MP and HP). The patients were then submitted to DS and those without DVT were rescheduled to repeat the examination in 24-48 hours and in 7 days. Patients positively diagnosed with DVT received proper treatment. All patients without DVT were summoned to return within 3 months. RESULTS: The incidence of DVT among all 489 patients was 39.1% (191); of these, 35.6% were identified in the first examination and 3.5% in the follow-up. Among patients categorized as LP the occurrence was 6.1%, 26.9% in the MP group and 79.5% in the HP group. On the follow-up exams the incidence of DVT in LP, MP and HP groups was 2.4, 7.8 e 13.2%, respectively. Among patients with negative DS, 62.4% attended the reevaluation in 3 months and only one presented worsening of symptoms. This patient was then diagnosed with popliteal DVT using DS. CONCLUSION:The results suggest that for patients with LP for DVT and negative DS, follow-up exams are not needed, since the occurrence of DVT was low in this group. This procedure simplifies the diagnostic process.

Keywords : Venous thrombosis; diagnosis; ultrasonics.

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