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J Korean Soc Emerg Med > Volume 27(1); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(1): 8-14.
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,
Received: July 16, 2015; Revised: July 20, 2015   Accepted: October 8, 2015.  Published online: February 29, 2016.
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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