A clinical score to rule out the concomitant presence of deep vein thrombosis in patients presenting with superficial vein thrombosis: The ICARO study. Issue 5 (November 2015)

• Record Type: Journal Article
• Authors: Pomero, F.; Di Minno, M.N.D.; Tamburini Premunian, E.; Malato, A.; Pasca, S.; Barillari, G.; Fenoglio, L.; Siragusa, S.; Di Minno, G.; Ageno, W.; Dentali, F.
• Is Part Of: Thrombosis research. Volume 136:Issue 5(2015)
• Page Start: 938
• Page End: 942
• Publication Date: 2015-11
• Subjects: Venous thrombosis -- Saphenous vein -- Pulmonary embolism -- Ultrasonography -- Risk factors; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2015.09.010
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Background: Superficial vein thrombosis (SVT) is commonly encountered in clinical practice. Recent studies have suggested that the concomitant presence of deep vein thrombosis (DVT) or pulmonary embolism (PE) at the time of SVT diagnosis is not uncommon, thus increasing the interest on this disease. Whether this coexistence is predicted by specific risk factors remains unknown. Aim of the study: To evaluate potential risk factors for DVT coexistence in patients presenting with acute objectively diagnosed SVT of the lower limbs and to develop a simple score entirely based on clinical variables to define the pre-test probability of DVT in these patients. Methods: A multicenter, retrospective cohort study on SVT patients was conducted. Information was collected on clinical signs and on risk factors for venous thrombosis. Results: 494 patients (mean age 56.3 ± 17.9 years, 64.2% women) were included. Concomitant DVT was found in 16.0% of patients. After multivariate analysis, we identified 5 independent variables that were used to develop the ICARO score: active malignancy (1.5 points), limb edema (1.5 points), rope-like sign (− 1 point), age ≥ 50 years (1 point), unprovoked SVT (− 1 point). The prevalence of concomitant DVT was 1.1% in the low-probability category (< 0 points), 12.0% in the intermediate-probability category (0 to 1 points), and 32.3% in the high probability category (≥ 1.5 points). Conclusions: The concomitant presence of major DVT is not negligible in patients with SVT. Our prediction score entirely based on simple clinical variables may be useful in assessing the risk of concomitant DVT in these patients. Highlights: A major DVT appears to be common in patients with SVT. Age > 50 years, cancer, and edema were associated with an increased risk of DVT. DVT appeared less common in idiopathic SVT and in patients with rope-like sign.