Prospective registry of diagnostic strategies applied on venous thromboembolism in intensive care units of Santa Fe

Carlos Alberto Becker, Ricardo Alcides Fernández, Jorge Paolantonio, Mario Lerman, Enrique Ucedo, Rafael Avila, Fernando Faccio, cristian Botta, Néstor Carrizo, Carla Obaid

Abstract


Introduction

Venous thromboembolism is a common disease with high morbidity and mortality which can be reduced drastically with early diagnosis and treatment. The diagnosis of venous thromboembolism faces two difficulties: the low clinical suspicion and the complexity of the technical resources required which are not always available, makingit difficult to apply the algorithms recommended by the guidelines.

Objectives

The evaluate the diagnostic strategies used by the intensive care units in the city of Santa Fe when venous thromboembolism suspected, and to identify if any diagnostic algorithm is applied and the degree of final uncertain diagnosis.

Methods

A prospective multicenter and observational registry of patients hospitalized with suspicion of venous thromboembolism[(deep venous thrombosis (DVT) and/or pulmonary embolism (PE)] was elaborated by all the adult intensive care units.ResultsOver a three and a half-month period, 3042 patients were hospitalized in the 19 intensive care units of the city. Venousthromboembolism was suspected in 83 patients (50 PE, 10DVT and 23 PE + DVT). The diagnosis was confirmed in 25(30.1%), was ruled out in 33 (39.8%) and remained uncertainin 25 (30.1%). The final uncertain diagnosis was 25.7% inprivate centers and 66.6% in public hospitals. The index of suspicion was 2.7% (range 0.9% to 8.8%). The algorithms recommended by guidelines were not systematically used.ConclusionsThis registry showed a low global index of suspicion for venous thromboembolism, the algorithms recommended byguidelines were not used and the final uncertain diagnosiswas 30.1%.


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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar