Few predictors of massive deep vein thrombosis

Hylton V. Joffe; Nils Kucher; Victor F. Tapson; Samuel Z. Goldhaber

doi:10.1160/TH05-05-0314

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 94(05): 986-990
DOI: 10.1160/TH05-05-0314

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Few predictors of massive deep vein thrombosis

Authors

Hylton V. Joffe

¹Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
Nils Kucher

¹Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
Victor F. Tapson

¹Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
Samuel Z. Goldhaber

¹Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

Abstract

Summary

Factors that predispose to thrombus propagation from the femoropopliteal veins to the pelvic veins are poorly understood. Our goal was to determine whether there are characteristics that identify patients with massive deep vein thrombosis (DVT). We compared the 122 (2.5%) patients presenting with massive DVT (pelvic plus lower-extremity DVT) to the 4,674 (97.5%) patients with isolated lower-extremity DVT from a prospective United States multicenter DVT registry. Patients with massive DVT were younger (59.4±18.9 years vs. 64.3±16.8 years; p<0.01), less likely to have hypertension (40% vs. 51%; p=0.02), and more likely to smoke (21% vs. 13%; p=0.02) and have on- going radiation therapy (7% vs. 3%; p=0.02). The massive DVT group more commonly presented with extremity edema (80% vs. 69%; p<0.01) and erythema (21% vs. 12%; p<0.01) than the isolated lower-extremity DVT group. However, after multivariable logistic regression analysis, extremity erythema (adjusted odds ratio 1.86; 95% CI 1.13–3.04) was the only independent sequela of massive DVT and younger age (adjusted odds ratio 1.17 per decreasing decade of age; 95% confidence interval: 1.02-1.34) was the only independent predictor of massive DVT. Thrombus propagation from the femoropopliteal system cannot be reliably predicted using demographic or clinical characteristics.

Keywords

Deep vein thrombosis - ultrasound / diagnosis - clinical / epidemiological studies

Full Text

References

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