Hasenbalg Bailey, Santarelli Anthony, Lyon Christopher, Sergent Shane, Choi Heesun, Ashurst John
Emergency Medicine, Kingman Regional Medical Center, Kingman, USA.
Emergency Medicine, Duke Lifepoint Memorial Medical Center, Johnstown, USA.
Cureus. 2021 Aug 5;13(8):e16911. doi: 10.7759/cureus.16911. eCollection 2021 Aug.
When used as a diagnostic aid for diagnosing deep vein thrombosis (DVT), venous duplex ultrasound (US) may reveal non-thrombotic findings in those with acute extremity pain. The objective of this study was to determine the prevalence and predictors of non-thrombotic findings on venous duplex US at a community emergency department.
A retrospective chart review of all adult patients who presented to a community emergency department who underwent either an upper or lower extremity venous duplex US for the evaluation of DVT from June 1, 2019, to September 15, 2020. All US studies were completed by certified sonographers and interpreted by board-certified radiologists. Two trained research assistants manually abstracted patient demographics and US findings. Data were analyzed using the chi-square statistic for categorical variables and the student's independent t-test for continuous variables. Multivariate binomial regression was used to identify independent predictors of non-thrombotic results on venous duplex US.
A total of 1,448 venous duplex US were obtained during the study period with 126 DVTs being diagnosed. A total of 1071 US had no acute abnormality and 252 had non-thrombotic findings. All non-thrombotic findings were found in the lower extremity. Of those with non-thrombotic findings, the most common diagnoses included edema (34.9%, 88/252), Baker's cyst (22.6%, 57/252), and an unspecified fluid collection (16.3%, 41/252). Patients with non-thrombotic findings were more likely to have a history of atrial fibrillation (p=0.001) or hypertension (p=0.001), be older than the age of 70 (p=0.042), or have a history of using illicit drugs (p=0.003). Females were less likely to have non-thrombotic findings.
In this single-site study, non-thrombotic findings were present in 23.5% of all venous duplex US completed at a community emergency department. These findings are more common in the elderly, those with cardiovascular disorders, and those who have used illicit drugs.
当静脉双重超声（US）用作诊断下肢深静脉血栓形成（DVT）的辅助手段时，对于有急性肢体疼痛的患者，可能会发现非血栓性表现。本研究的目的是确定社区急诊科静脉双重超声检查中非血栓性表现的患病率及预测因素。
对2019年6月1日至2020年9月15日期间在社区急诊科就诊并接受上肢或下肢静脉双重超声检查以评估DVT的所有成年患者进行回顾性病历审查。所有超声检查均由认证超声医师完成，并由具有委员会认证的放射科医生解读。两名经过培训的研究助理手动提取患者人口统计学信息和超声检查结果。使用卡方统计量分析分类变量，使用学生独立t检验分析连续变量。多变量二项式回归用于确定静脉双重超声检查中非血栓性结果的独立预测因素。
在研究期间共进行了1448次静脉双重超声检查，诊断出126例DVT。共有1071次超声检查无急性异常，252次有非血栓性表现。所有非血栓性表现均见于下肢。在有非血栓性表现的患者中，最常见的诊断包括水肿（34.9%，88/252）、腘窝囊肿（22.6%，57/252）和未明确的液体积聚（16.3%，41/252）。有非血栓性表现的患者更有可能有房颤病史（p = 0.001）或高血压病史（p = 0.001），年龄大于70岁（p = 0.042），或有使用非法药物史（p = 0.003）。女性出现非血栓性表现的可能性较小。
在这项单中心研究中，社区急诊科完成的所有静脉双重超声检查中有23.5%存在非血栓性表现。这些表现在老年人、患有心血管疾病的人和使用过非法药物的人中更为常见。
