Limitations of impedance plethysmography in the diagnosis of clinically suspected deep-vein thrombosis: Anderson DR, Lensing AWA, Wells PS, et al Ann Intern Med 118:25–30 Jan 1993
✍ Scribed by Thomas J Deskin
- Book ID
- 104311313
- Publisher
- Elsevier Science
- Year
- 1993
- Tongue
- English
- Weight
- 63 KB
- Volume
- 22
- Category
- Article
- ISSN
- 1097-6760
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✦ Synopsis
The authors retrospectively evaluate the accuracy of impedance plethysmography in the diagnosis of proximal deep venous thrombosis in a cohort of 386 patients during a 22month period. The plethysmography results were abnormal initially in 53 patients and on ~erial testing in an additional five patients. 0nly 37 of these 58 patients had the diagnosis of proximal deep vein thrombosis confirmed by either venography or compression ultrasound (positive predictive value, 65%). Eighty-five patients with normal plethysmography were referred for compression ultrasound or venography because of high clinical suspicion or inability to perform serial plethysmography testing. Proximal deep vein thrombosis was detected in 22% of these patients (17 by venogram and two by compression ultrasound). Thus, proximal deep vein thrombosis was diagnosed in 56 patients (47 by venography and nine by compression ultrasound). Plethysmography correctly identified only 37 of these patients (sensitivity, 66%; 95% confidence interval, 52% to 78%). Most of the thrombi missed by plethysmography were large and occlusive. The authors recommend that centers using plethysmography as the iniiial diagnostic test for deep vein thrombosis re-evaluate the sensitivity of their test.