Document Detail


Accuracy of Ultrasonography Performed by Critical Care Physicians for the Diagnosis of DVT.
MedLine Citation:
PMID:  21030490     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Pierre D Kory; Crescens M Pellecchia; Ariel L Shiloh; Paul H Mayo; Christopher Dibello; Seth Koenig
Publication Detail:
Type:  Journal Article     Date:  2010-10-28
Journal Detail:
Title:  Chest     Volume:  139     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  538-42     Citation Subset:  AIM; IM    
Affiliation:
MPA, Beth Israel Medical Center, Division of Pulmonary, Critical Care and Sleep Medicine, 7th Floor, Dazian Bldg, 16th St and 1st Ave, New York, NY 10003. pkory@chpnet.org.
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