| Accuracy of Ultrasonography Performed by Critical Care Physicians for the Diagnosis of DVT. | |
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MedLine Citation:
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PMID: 21030490 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Pierre D Kory; Crescens M Pellecchia; Ariel L Shiloh; Paul H Mayo; Christopher Dibello; Seth Koenig |
Publication Detail:
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Type: Journal Article Date: 2010-10-28 |
Journal Detail:
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Title: Chest Volume: 139 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 538-42 Citation Subset: AIM; IM |
Affiliation:
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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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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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