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A Journal on Phlebology
Acta Phlebologica 2007 August;8(2):67-9
Late diagnosis of DVT: a persisting problem
Arpaia G. 1, Mastrogiacomo O. 1, Carpenedo M. 1, De Gaudenzi E. 2, Milani M. 1, Cimminiello C. 1
1 Unit of Internal Medicine Department of Angiology and Vascular Diagnostics Azienda Ospedaliera “Ospedale Civile”, Vimercate, Milan
2 Department of Internal Medicine Ambulatory of Angiology and Thrombosis Azienda Ospedaliera di Domodossola, Novara, Italy
Aim. Despite ample coverage in the scientific literature and the fact that many hospitals and outpatient clinics have the equipment for ultrasound (US) diagnosis, deep venous thrombosis (DVT) is still often diagnosed only long after the appearance of symptoms such as swelling of part or all of the lower leg.
Methods. During enrolment for a study of two different compression therapy strategies in the acute phase of DVT, we collected information on the time elapsed between the appearance of swelling in the leg, as reported by the patient him/herself, and US diagnosis.
Results. The delay in diagnosis in both groups of patients was substantial (9.6 ± 12.0 and 6.6 ± 6.6 days), but apparently not significantly related to the therapeutic efficacy of low-molecular-weight heparin (LMWH) with warfarin, or LMWH alone together with a prescription for therapeutic class 2 compression elastic hosiery.
Conclusion. It was not possible to draw any firm conclusion on whether prompt diagnosis affected the prognosis.