Deep vein thrombosis patients with negative ultrasound and no anticoagulant at low risk-- Jeff Muise
Tuesday, February 2, 2010 (Last Updated: 02/03/2010)
TUESDAY, Feb. 2 (HealthDay News) -- In patients with suspected lower extremity deep vein thrombosis (DVT), those with a negative whole-leg compression ultrasound (CUS) and no anticoagulation therapy are at low risk of venous thromboembolism, according to a meta-analysis reported in the Feb. 3 issue of the Journal of the American Medical Association.
In order to track the incidence of venous thromboembolism events, Stacy A. Johnson, M.D., of the University of Utah School of Medicine in Salt Lake City, and colleagues reviewed the medical literature from 1970 to 2009 for randomized trials and prospective studies of patients with suspected DVT, a negative whole-leg CUS, non-receipt of anticoagulant therapy, and follow-up of 90 days or more. The reviewers screened 156 studies before including 7 studies comprising 4,731 subjects in their meta-analysis.
The reviewers found that 34 deaths (0.7 percent) from venous thromboembolism or suspected venous thromboembolism occurred in the combined study cohort. The patients who died included 11 with distal DVT (32.4 percent), seven with proximal DVT (20.6 percent), seven with nonfatal pulmonary emboli (20.6 percent), and nine (26.5 percent) whose deaths were thought related to venous thromboembolism. In the pooled analysis, the combined venous thromboembolism event rate at three months was 0.57 percent.
"Withholding anticoagulation following a single negative whole-leg CUS result was associated with a low risk of venous thromboembolism during three-month follow-up," the authors write.
One study author reported receiving consulting and speaker fees from several pharmaceutical companies.
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