| 심부정맥혈전증으로 응급실에 내원한 환자에서 폐동맥색전증을 진단하기 위한 검사가 필요한가? |
| 김태림, 유승목, 안신, 손창환, 서동우, 이재호, 이윤선, 임경수, 김원영 |
| 울산대학교 의과대학 서울아산병원 응급의학교실 |
| Do We Have to Check Pulmonary Thromboembolism in Patients with Deep Vein Thrombosis in Emergency Department? |
| Taerim Kim, Seung Mok Ryoo, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Yoon Seon Lee, Kyung Soo Lim, Won Young Kim |
| Department of Emergency Medicine, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea |
| Correspondence |
Won Young Kim ,Tel: 02) 3010-3350, Fax: 02) 3010-3360, Email: wonpia73@naver.com,
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Received: July 16, 2015; Revised: July 20, 2015 Accepted: October 8, 2015. Published online: February 29, 2016. |
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| ABSTRACT |
Purpose:
Deep vein thrombosis (DVT) is a risk factor of pulmonary thromboembolism (PTE), however it is not clear who should be evaluated for a PTE and a DVT at the same time. The purpose of this study is to determine the clinical characteristics of PTE in patients with DVT who visited the emergency department (ED).
Method:
This was a retrospective cohort study of ED patients who visited with DVT and were simultaneously evaluated for a PTE from January 2012 to December 2013. We compared clinical characteristics between non-PTE and PTE patients with confirmed DVT in the ED.
Results:
Of these 166 patients, 96 patients (57.8%) were confirmed PTE by computed tomography. In multivariate analysis, patients with PTE had more systemic neoplasm (OR 2.03, 95% CI 1.04-3.93, p=0.037) and right heart strain pattern in electrocardiography (OR 5.29, 95% CI 1.71-16.36, p=0.004) than patients without PTE. Femoral DVT was more likely in the non-PTE group (87.1% vs. 65.6%, p=0.002) and popliteal DVT was more likely in the PTE group (62.9% vs. 80.2%, p=0.013). However the number of DVT sites including both femoral and popliteal vein was not statistically different.
Conclusion:
In patients with systemic neoplasm or right heart strain patterns in electrocardiography, simultaneous PTE evaluation may be required in patients with DVT. |
| Key words:
Venous thrombosis, Thromboembolism, Multidetector computed tomography |
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