Evaluation of clinical model for deep vein thrombosis: a cheap alternative for developing countries
AbstractBackground: Deep vein thrombosis is an important cause of morbidity and mortality worldwide. The clinical features are non-specific and the clinical diagnosis is unreliable. The objective testing for the correct diagnosis is not usually available in most developing countries and the expertise are not readily available couple with the high cost of such investigations.
Objectives: This study was intended therefore to evaluate a validated clinical model for deep vein thrombosis and to see if there is correlation between the clinical model and results of the Doppler sonography, in suspected cases of deep vein thrombosis.
Method: A prospective evaluation of 21 inpatients with suspected deep vein thrombosis seen at the department of Haematology and Radiology of the University of Maiduguri Teaching Hospital over a period of 24 months from October 2002 to October 2004.
Results: Twelve (57.1% of the 21 patients evaluated had a high pretest clinical probability score of 3 and above, 6(28.6%) of them had intermediate score of 1 or 2 and 3 (14.3%) had a low score of 0 or less. There was a 100% correlation between the high-risk categories and the ultrasound findings and no correlation for both the intermediate and the low-risk categories.
Conclusion: The study suggest that a high pretest clinical probability score of 3 and above is reliable for the diagnosis of deep vein thrombosis and treatment can be initiated in at least emergency situation without much delay. Also a D-dimer assay is recommended for all patients with a low or intermediate pretest clinical probability score so as to avoid unnecessary use of ultrasonography.
Keywords: clinical model, DVT, developing countries
Sahel Medical Journal Vol. 9(1) 2006: 15-18