Predictability of symptoms of upper extremity deep venous thrombosis in patients with central lines: A follow-up

J. M. Stanley, R. S. McGrath, Michael Freeman, Scott Stevens, Mitchell Goldman

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Abstract

Upper extremity deep venous thrombosis (DVT) has become more common with the increasing use of central lines for diagnostic and therapeutic manipulations. Central line placement is now considered a major risk factor for upper extremity DVT. Our initial investigation concluded that in patients with central lines, a combination of upper extremity pain and swelling has a high correlation with upper extremity DVT. The purpose of this study is to continue the initial investigation with a larger, more significant patient population to see if the correlation still exists and if so, with higher statistical significance. All upper extremity venous duplex examinations were retrospectively reviewed from January 1992 through December 1993. A total of 63 patients with a prior history of central line placement were identified. From that group, two patients had bilateral central line placement giving a total of 65 upper extremities available for study. A high-resolution, real- time color duplex imager was used to determine the presence of upper extremity DVT. Of the 65 upper extremities, 35 presented with the combination of pain and swelling. DVT was positive in 80% (n = 28) of these upper extremities. In the initial study, only eight upper extremities (out of 25) presented with the combination of pain and swelling, of which 75% (n = 6) had upper extremity DVT. In this study, the sensitivity of using the combination of pain and swelling to predict upper extremity DVT in patients with central lines is 77%, the positive predictive value is 80%, and the accuracy is 77% (p = 0.001). In the initial study, the sensitivity was 50%, positive predictive value 75%, and the accuracy 68%. It is apparent from this follow- up study that in patients with central lines, the combination of upper extremity pain and swelling has a correlation with upper extremity DVT. A larger patient population was used for this study, which produced a higher sensitivity, positive predictive value, and accuracy than the initial study and we believe that as more patients are added to this study, the accuracy will increase.

Original languageEnglish (US)
Pages (from-to)33-35
Number of pages3
JournalJournal of Vascular Technology
Volume20
Issue number1
StatePublished - Jan 1 1996

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Upper Extremity
Venous Thrombosis
Pain
Population
Color

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Predictability of symptoms of upper extremity deep venous thrombosis in patients with central lines: A follow-up",
abstract = "Upper extremity deep venous thrombosis (DVT) has become more common with the increasing use of central lines for diagnostic and therapeutic manipulations. Central line placement is now considered a major risk factor for upper extremity DVT. Our initial investigation concluded that in patients with central lines, a combination of upper extremity pain and swelling has a high correlation with upper extremity DVT. The purpose of this study is to continue the initial investigation with a larger, more significant patient population to see if the correlation still exists and if so, with higher statistical significance. All upper extremity venous duplex examinations were retrospectively reviewed from January 1992 through December 1993. A total of 63 patients with a prior history of central line placement were identified. From that group, two patients had bilateral central line placement giving a total of 65 upper extremities available for study. A high-resolution, real- time color duplex imager was used to determine the presence of upper extremity DVT. Of the 65 upper extremities, 35 presented with the combination of pain and swelling. DVT was positive in 80{\%} (n = 28) of these upper extremities. In the initial study, only eight upper extremities (out of 25) presented with the combination of pain and swelling, of which 75{\%} (n = 6) had upper extremity DVT. In this study, the sensitivity of using the combination of pain and swelling to predict upper extremity DVT in patients with central lines is 77{\%}, the positive predictive value is 80{\%}, and the accuracy is 77{\%} (p = 0.001). In the initial study, the sensitivity was 50{\%}, positive predictive value 75{\%}, and the accuracy 68{\%}. It is apparent from this follow- up study that in patients with central lines, the combination of upper extremity pain and swelling has a correlation with upper extremity DVT. A larger patient population was used for this study, which produced a higher sensitivity, positive predictive value, and accuracy than the initial study and we believe that as more patients are added to this study, the accuracy will increase.",
author = "Stanley, {J. M.} and McGrath, {R. S.} and Michael Freeman and Scott Stevens and Mitchell Goldman",
year = "1996",
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T1 - Predictability of symptoms of upper extremity deep venous thrombosis in patients with central lines

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AU - Freeman, Michael

AU - Stevens, Scott

AU - Goldman, Mitchell

PY - 1996/1/1

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N2 - Upper extremity deep venous thrombosis (DVT) has become more common with the increasing use of central lines for diagnostic and therapeutic manipulations. Central line placement is now considered a major risk factor for upper extremity DVT. Our initial investigation concluded that in patients with central lines, a combination of upper extremity pain and swelling has a high correlation with upper extremity DVT. The purpose of this study is to continue the initial investigation with a larger, more significant patient population to see if the correlation still exists and if so, with higher statistical significance. All upper extremity venous duplex examinations were retrospectively reviewed from January 1992 through December 1993. A total of 63 patients with a prior history of central line placement were identified. From that group, two patients had bilateral central line placement giving a total of 65 upper extremities available for study. A high-resolution, real- time color duplex imager was used to determine the presence of upper extremity DVT. Of the 65 upper extremities, 35 presented with the combination of pain and swelling. DVT was positive in 80% (n = 28) of these upper extremities. In the initial study, only eight upper extremities (out of 25) presented with the combination of pain and swelling, of which 75% (n = 6) had upper extremity DVT. In this study, the sensitivity of using the combination of pain and swelling to predict upper extremity DVT in patients with central lines is 77%, the positive predictive value is 80%, and the accuracy is 77% (p = 0.001). In the initial study, the sensitivity was 50%, positive predictive value 75%, and the accuracy 68%. It is apparent from this follow- up study that in patients with central lines, the combination of upper extremity pain and swelling has a correlation with upper extremity DVT. A larger patient population was used for this study, which produced a higher sensitivity, positive predictive value, and accuracy than the initial study and we believe that as more patients are added to this study, the accuracy will increase.

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