Improved selection criteria for ordering stat venous ultrasounds from the emergency department

Paul A. Armstrong, James B. Peoples, William A. Vitello, Gary W. Lemmon

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

BACKGROUND: The accuracy and convenience of venous ultrasound (VU) to exclude deep vein thrombosis (DVT) has led to indiscriminate use and low positive yield rates. METHODS: A total of 256 patients were referred from our emergency department (ED) for stat VU during a 2-year period (1995 to 1996). The VUs were interpreted as normal in 198 (77%). Positive findings were discovered in 58 (23%), with DVT accounting for 43 (17%). Retrospective multivariant analysis was used to identify predictive indicators. RESULTS: Unilateral leg swelling/edema identified 36 of 40 (90%) patients with DVT and 8 of 10 (80%) with other thrombotic disorders (saphenous and/or chronic venous thrombosis). A history of leg pain with prior DVT or recent trauma ≤3 days' duration increased DVT duration to 98% (39 of 40). Using these criteria, a 47% charge reduction would have been recognized. CONCLUSIONS: Improving ED screening criteria can safely increase yield rate and reduce charges with minimal loss of VU sensitivity.

Original languageEnglish (US)
Pages (from-to)226-228
Number of pages3
JournalAmerican Journal of Surgery
Volume176
Issue number2
DOIs
StatePublished - Aug 1 1998
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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