Prevalence of asymptomatic deep vein trombosis of the legs: defining risk factors that indicate the need for investigation of assyptomatic contralateral limb: retrospective study

• Grant number: 12/20188-1
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: March 01, 2013
• End date: February 28, 2014
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Marcone Lima Sobreira
• Grantee: Bárbara Pimenta
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

There is still controversy about the real need for systematic bilateral investigation of patients with only 01 symptomatic extremities deep venous thrombosis (DVT), whether ambulatory or hospitalized. Increasingly, comprehensive care to the patient's health has become a requirement, which has caused an increase in medical and hospital costs, mainly related to new medical technologies. DVT is a condition with significant prevalence in the general population and with significant morbidity as regards the quality of life and survival. Its major complications are: 1) the post-thrombotic syndrome (PTS) - where the patient may develop venous insufficiency of the affected extremity with clinical repercussions on the quality of life and may remove him from active life, becoming an important cause of absenteeism in our environment and 2) pulmonary embolism (PE) - which may be responsible for respiratory failure and, in many cases, prolonging hospital staying and may even lead to death. In U.S. surveys, it is estimated that there are about 500,000 people with PE, while 10% will die, 11% of these occur in the first hour. Regarding DVT, there is still no standardization to assist in identifying which patients should be investigated bilaterally, independent of symptomatology. It is known that hospitalized patients - regardless of the cause - are at increased risk for thromboembolic complications compared to the outpatient population. The vascular laboratories have attempted to identify those most at risk and find markers that facilitate the identification of these patients, the development of protocols based on the clinical history and laboratory tests, with the aim of reducing costs. Some authors advocate ultrasound investigation limited to the symptomatic extremity. On the other hand, others argue for the systematic investigation of the ends - regardless of symptoms - especially in those patients with risk factors predispose to thromboembolic complications. In an effort to better understand the risk related to thromboembolic disease and to identify markers that identify the population who would benefit from bilateral research, with consequent risk reduction. We intend to review file data from the vascular laboratory (FMB-UNESP) for all patients who were referred to our clinic for investigation of DVT and that there was confirmation of the diagnosis in the symptomatic end from February 2005 until April 2012 in an attempt to meet potential markers/risk situations that are related to the development of asymptomatic DVT, thereby identifying clinical situations where the research should be done more aggressively.(AU)