Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study

Y Objectives. To describe the characteristics of patients with isolated lower-limb superficial vein thrombosis (SVT) treated in hospital emergency departments and to evaluate adherence to clinical practice guidelines on diagnosis (vein ultrasound imaging) and therapeutic management (start of anticoa...

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Autores: Chaib, FB, Hernandez, SJ, Navas, JMP, Mancilla, JC, Arias, LC, Loranca, MM, Gomez, AP, Marquez, AA, Polo, LP, Garrido-Lestache, AS, Lecumberri, R, Artacho, PR
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p6289
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6289
Access Level:acceso abierto
Palabra clave:Venous thrombosis, superficial
Thromboembolic disease
Emergency department
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spelling Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA studyChaib, FBHernandez, SJNavas, JMPMancilla, JCArias, LCLoranca, MMGomez, APMarquez, AAPolo, LPGarrido-Lestache, ASLecumberri, RArtacho, PRVenous thrombosis, superficialThromboembolic diseaseEmergency departmentY Objectives. To describe the characteristics of patients with isolated lower-limb superficial vein thrombosis (SVT) treated in hospital emergency departments and to evaluate adherence to clinical practice guidelines on diagnosis (vein ultrasound imaging) and therapeutic management (start of anticoagulant therapy). Methods. Retrospective cohort study in 18 Spanish emergency departments. We included all patients with a final emergency department diagnosis of lower-limb SVT aged 18 years or older between January 2016 and May 2017. Backward stepwise multiple logistic regression analysis was used to evaluate adherence to clinical practice guidelines on ordering vein ultrasound imaging and starting anticoagulant therapy. Results. A total of 1166 patients were included. The mean patient age was 59.6 years, and 67.9% were women. About a quarter of the patients (24.4%) had a history of venous thromboembolic disease. Complications developed in 8.9% within 180 days: 4.6% experienced a recurrence and 3.6% progressed to SVT and 1.8% to deep vein thrombosis; pulmonary thromboembolism occurred in 0.9%. Hemorrhagic complications developed in 17 patients (1.5%). Sixteen patients (1.4%) died. Vein ultrasound imagine was ordered for 703 patients (60.3%). Anticoagulant agents were prescribed for 898 (77%) for a median period of 22 days. Variables associated with a decision to order anticoagulants were a history of venous thromboembolic disease (odds ratio [OR], 1.60; 95% CI, 1.12-2.30), varicose veins (OR, 1.40; 95% CI, 1.12-2.30); limb pain (OR, 1.44; 95% CI, 1.08-1.91); painful cord (OR, 1.30; 95% CI, 0.97-1.73); and availability of vein ultrasound images (OR, 1.60; 95% CI, 1.94-3.45). Conclusions. Adherence to clinical practice guidelines for the diagnosis and treatment of isolated lower-limb SVT is low in Spanish emergency departments. Ultrasound imaging is not ordered for 1 out of every 2 to 3 patients, and anticoagulant treatment is not started in 1 out of 4 patients. There is great room for improvement.SANIDAD EDICIONES2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6289EMERGENCIASISSN: 11376821ISSNe: 23865857reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Españolinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p62892026-06-14T12:41:47Z
dc.title.none.fl_str_mv Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
title Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
spellingShingle Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
Chaib, FB
Venous thrombosis, superficial
Thromboembolic disease
Emergency department
title_short Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
title_full Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
title_fullStr Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
title_full_unstemmed Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
title_sort Characteristics of isolated superficial vein thrombosis and diagnostic-therapeutic management in Spanish hospital emergency departments: the ALTAMIRA study
dc.creator.none.fl_str_mv Chaib, FB
Hernandez, SJ
Navas, JMP
Mancilla, JC
Arias, LC
Loranca, MM
Gomez, AP
Marquez, AA
Polo, LP
Garrido-Lestache, AS
Lecumberri, R
Artacho, PR
author Chaib, FB
author_facet Chaib, FB
Hernandez, SJ
Navas, JMP
Mancilla, JC
Arias, LC
Loranca, MM
Gomez, AP
Marquez, AA
Polo, LP
Garrido-Lestache, AS
Lecumberri, R
Artacho, PR
author_role author
author2 Hernandez, SJ
Navas, JMP
Mancilla, JC
Arias, LC
Loranca, MM
Gomez, AP
Marquez, AA
Polo, LP
Garrido-Lestache, AS
Lecumberri, R
Artacho, PR
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Venous thrombosis, superficial
Thromboembolic disease
Emergency department
topic Venous thrombosis, superficial
Thromboembolic disease
Emergency department
description Y Objectives. To describe the characteristics of patients with isolated lower-limb superficial vein thrombosis (SVT) treated in hospital emergency departments and to evaluate adherence to clinical practice guidelines on diagnosis (vein ultrasound imaging) and therapeutic management (start of anticoagulant therapy). Methods. Retrospective cohort study in 18 Spanish emergency departments. We included all patients with a final emergency department diagnosis of lower-limb SVT aged 18 years or older between January 2016 and May 2017. Backward stepwise multiple logistic regression analysis was used to evaluate adherence to clinical practice guidelines on ordering vein ultrasound imaging and starting anticoagulant therapy. Results. A total of 1166 patients were included. The mean patient age was 59.6 years, and 67.9% were women. About a quarter of the patients (24.4%) had a history of venous thromboembolic disease. Complications developed in 8.9% within 180 days: 4.6% experienced a recurrence and 3.6% progressed to SVT and 1.8% to deep vein thrombosis; pulmonary thromboembolism occurred in 0.9%. Hemorrhagic complications developed in 17 patients (1.5%). Sixteen patients (1.4%) died. Vein ultrasound imagine was ordered for 703 patients (60.3%). Anticoagulant agents were prescribed for 898 (77%) for a median period of 22 days. Variables associated with a decision to order anticoagulants were a history of venous thromboembolic disease (odds ratio [OR], 1.60; 95% CI, 1.12-2.30), varicose veins (OR, 1.40; 95% CI, 1.12-2.30); limb pain (OR, 1.44; 95% CI, 1.08-1.91); painful cord (OR, 1.30; 95% CI, 0.97-1.73); and availability of vein ultrasound images (OR, 1.60; 95% CI, 1.94-3.45). Conclusions. Adherence to clinical practice guidelines for the diagnosis and treatment of isolated lower-limb SVT is low in Spanish emergency departments. Ultrasound imaging is not ordered for 1 out of every 2 to 3 patients, and anticoagulant treatment is not started in 1 out of 4 patients. There is great room for improvement.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6289
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6289
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SANIDAD EDICIONES
publisher.none.fl_str_mv SANIDAD EDICIONES
dc.source.none.fl_str_mv EMERGENCIAS
ISSN: 11376821
ISSNe: 23865857
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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