A study published in The Clinical Respiratory Journal suggests there may be a reduced incidence of deep vein thrombosis (DVT) in patients who are at high or intermediate risk of pulmonary embolism (PE).
The study was a retrospective analysis of DVT incidence in 392 patients who were treated for PE between August 2015 and November 2016 at the First Affiliated Hospital of Chongqing Medical University in China. Patients were categorized into 3 risk levels (low, intermediate, or high) for PE based on characteristics at the time of PE diagnosis, according to 2014 European Society of Cardiology (ESC) Guidelines. A goal of this study was to determine whether DVT incidence is linked to PE risk.
Approximately half of the patients (50.3%) were considered to be at low risk for PE by the ESC Guidelines, while 43.6% showed an intermediate risk, and 6.1% were at high risk. Overall, most patients (77.6%) showed evidence of coexisting DVT.
Patients considered to be at low risk of PE had a DVT incidence of 87.8%, while DVT incidence was 67.2% for patients in high and intermediate PE risk categories (P <.0001).
Some subclassifications of DVT were associated with higher PE risk. High or intermediate PE risk status was significantly more common with asymptomatic DVT (63.0%) than with symptomatic DVT (36.7%; P <.0001). Among patients with DVTs, the occurrence of asymptomatic DVT was independently linked to high or intermediate PE risk.
High or intermediate PE risk was found in more patients with distal DVT (59.0%) than with proximal DVT (39.1%; P =.005). Additionally, high or intermediate PE risk was found in 54.5% of patients with bilateral DVT, compared with a rate of 40.0% for unilateral DVT (P =.03).
The study investigators concluded that high or intermediate PE risk status was linked with lower rates of DVT, but asymptomatic DVT was more often found with high or intermediate PE risk.“DVT might contribute to assessing the severity of patients with PE in advance,” the study investigators said in their report.
Wang XH, Cui LB, Liu Y, et al. Association between risk stratification for pulmonary embolism and deep vein thrombosis of lower extremities [published online March 3, 2020]. Clin Respir J. doi: 10.1111/crj.13177