Abstract:
BACKGROUND:DVT is common among critically ill patients. A rapid and accurate diagnosis is essential for patient care. We assessed the accuracy and timeliness of intensivist-performed compression ultrasonography studies (IP-CUS) for proximal lower extremity DVT (PLEDVT) by comparing results with the formal vascular study (FVS) performed by ultrasonography technicians and interpreted by radiologists. METHODS:We conducted a multicenter, retrospective review of IP-CUS examinations performed in an ICU by pulmonary and critical care fellows and attending physicians. Patients suspected of having DVT underwent IP-CUS, using a standard two-dimensional compression ultrasonography protocol for the diagnosis of PLEDVT. The IP-CUS data were collected prospectively as part of a quality-improvement initiative. The IP-CUS interpretation was recorded and timed at the end of the examination on a standardized report form. An FVS was then ordered, and the FVS result was used as the criterion standard for calculating sensitivity and specificity. Time delays between the IP-CUS and FVS were recorded. RESULTS:A total of 128 IP-CUS were compared with an FVS. Eighty-one percent of the IP-CUS were performed by fellows with <2 years of clinical ultrasonography experience. Prevalence of DVT was 20%. IP-CUS studies yielded a sensitivity of 86% and a specificity of 96% with a diagnostic accuracy of 95%. Median time delay between the ordering of FVS and the FVS result was 13.8 h. CONCLUSIONS:Rapid and accurate diagnosis of proximal lower extremity DVT can be achieved by intensivists performing compression ultrasonography at the bedside.
journal_name
Chestjournal_title
Chestauthors
Kory PD,Pellecchia CM,Shiloh AL,Mayo PH,DiBello C,Koenig Sdoi
10.1378/chest.10-1479subject
Has Abstractpub_date
2011-03-01 00:00:00pages
538-542issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(11)60120-7journal_volume
139pub_type
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