A Prospective Study of a Focused, Surgeon-Performed Ultrasound Examination for the Detection of Occult Common Femoral Vein Thrombosis in Critically Ill Patients

• Published in: Archives of surgery (Chicago. 1960) Vol. 139; no. 3; pp. 275 - 280
• Main Authors: Rozycki, Grace S, Tchorz, Kathryn M, Riehle, Kimberly J, Hattaway, Aaron, Naidu, Deepak K
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Medical Association 01.03.2004
• Subjects: Adult; Aged; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Critical Illness; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Femoral Vein - diagnostic imaging; General aspects; Humans; Intensive Care Units; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Prospective Studies; Ultrasonography; Venous Thrombosis - diagnostic imaging; Sonography; Human; Critically ill; Cardiovascular disease; Surgeon; Venous disease; Vascular disease; Medicine; Prospective; Treatment; Surgery; Echography; Venous thrombosis; Ultrasound; Femoral vein
• ISSN: 0004-0010; 2168-6254; 1538-3644; 2168-6262
• DOI: 10.1001/archsurg.139.3.275

HYPOTHESIS A focused, surgeon-performed ultrasound examination of the common femoral veins is an accurate screening tool for the detection of common femoral vein thrombosis in high-risk, critically ill patients. DESIGN A prospective study using a focused ultrasound examination for findings consistent with deep vein thrombosis of the common femoral veins. The results of these examinations were compared with those of duplex imaging or computed tomographic venography studies. SETTING Surgical intensive care unit. PATIENTS All critically ill patients who were admitted to the surgical intensive care unit and considered to be at high risk for the development of deep vein thrombosis. MAIN OUTCOME MEASURE Presence of deep vein thrombosis in the common femoral veins. RESULTS During a 16-month period, surgeons performed 306 ultrasound examinations on 220 critically ill surgical patients. The results included 295 true negative, 9 true positive, 1 false negative, and 1 false positive, yielding a 90.0% sensitivity, 99.6% specificity, and 99.3% accuracy. CONCLUSION A focused, surgeon-performed ultrasound examination is a rapid and accurate screening method to detect common femoral vein thrombosis in critically ill patients as well as to examine those patients in whom pulmonary embolism is strongly suspected.Arch Surg 2004;139:275-280-->