Background. Deep vein thrombosis (DVT) is a common condition with significant mortality and morbidity. Proximal DVT is more often associated with pulmonary embolism and the post-phlebitic syndrome than calf DVT. Identifying which clinical variables predict DVT and proximal DVT could be useful for the effective targeting of diagnostic tests for DVT. / Purpose. To determine, in patients presenting with leg symptoms, which clinical variables best predict (1) DVT and (2) proximal DVT. To estimate the probability of DVT in an individual presenting with a particular grouping of these variables. / Results. Male sex, orthopedic surgery, and warmth and superficial venous dilation on exam were independent predictors of DVT (adjusted odds ratios and 95% confidence intervals 2.8 (1.5, 5.1), 5.4 (2.2, 13.6), 2.1 (1.2, 3.9) and 2.9 (1.4, 5.7), respectively) and proximal DVT (adjusted odds ratios 2.4 (1.2, 4.8), 4.1 (1.4, 12.3), 2.3 (1.2, 4.7) and 3.4 (1.6, 7.0), respectively). A clinical prediction index that categorized patients into different levels of DVT risk was created, and its ROC curve showed moderate predictive ability. No single cutoff point was ideal in terms of desired sensitivity and specificity, however the index was useful in a strategy aimed to limit the need for contrast venography in patients with suspected DVT. Using this strategy, 78% of study patients could have avoided contrast venography. (Abstract shortened by UMI.)
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.27355 |
| Date | January 1996 |
| Creators | Kahn, Susan Rebecca. |
| Contributors | Abenhaim, L. (advisor), Joseph, L. (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001548739, proquestno: MQ29730, Theses scanned by UMI/ProQuest. |
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