How is deep vein thrombosis diagnosed and managed in UK and Australian emergency departments?

Full text for this resource is not available from the Research Repository.

Sampson, F. C, Goodacre, S, Kelly, Anne-Maree and Kerr, Debra (2005) How is deep vein thrombosis diagnosed and managed in UK and Australian emergency departments? Emergency Medicine Journal, 22 (11). pp. 780-782. ISSN 1472-0205 (print) 1472-0213 (online)

Abstract

Background: Recent research has identified technologies that may be of value in the diagnosis and management of deep vein thrombosis (DVT). We aimed to survey current practice in the United Kingdom (UK) and Australia to determine the extent to which these technologies have been implemented in these two healthcare systems. Methods: We undertook a postal survey of 255 hospitals in the UK and 89 hospitals in Australia, requesting details of individual diagnostic tests, use of diagnostic algorithms, and management of DVT. Results: We received replies from 186/255 UK hospitals (73%) and 84/89 of Australian hospitals (94%). Ultrasonography and laboratory based D-dimer were the most commonly available tests. We received 43 different algorithms from 51 hospitals. With only a very few exceptions, DVT diagnosis was ruled in by positive venography or positive ultrasound without venographic confirmation. By contrast a variety of different criteria were used to rule out DVT. Most algorithms used a combination of low clinical risk and negative D-dimer to rule out DVT, but some required all patients to receive ultrasound or venography. Few ruled out on the basis of low clinical risk or negative D-dimer alone. Low molecular weight heparins were overwhelmingly the treatment of choice for established DVT. Most departments (214/264; 81%) offered outpatient treatment. Conclusion: Recently developed technologies for the diagnosis and treatment of DVT have been widely implemented in the UK and Australia. Variation in practice, and thus presumably uncertainty, seems to be greatest in relation with the criteria used to rule out DVT.

Dimensions Badge

Altmetric Badge

Item type Article
URI https://vuir.vu.edu.au/id/eprint/21531
DOI https://doi.org/10.1136/emj.2004.020610
Official URL http://emj.bmj.com/content/22/11/780.full
Subjects Historical > Faculty/School/Research Centre/Department > School of Biomedical and Health Sciences
Current > FOR Classification > 1102 Cardiorespiratory Medicine and Haematology
Current > FOR Classification > 1103 Clinical Sciences
Keywords deep vein thrombosis, DVT, clinical scoring, D-dimer, plethysmography, ultrasound, molecular weight heparin, emergency department, ED, Australian healthcare system, computed tomography scanning, CT scanning, diagnostic testing
Citations in Scopus 16 - View on Scopus
Download/View statistics View download statistics for this item

Search Google Scholar

Repository staff login