Non-compressibility ratio of sonography in deep venous thrombosis.

BACKGROUND The risk of post-thrombotic syndrome and pulmonary embolism can be increased if there is failure to diagnose deep venous thrombosis (DVT) promptly. Emergency physicians (EPs) need a quick and readily available test to diagnose, treat and help them decide whether to discharge or admit DVT patients in a timely manner. The aim of this study was to investigate the value of the non-compressibility ratio of thrombosed veins in DVT patients, and give EPs an objective value to aid them in their decision-making with regard to DVT patients in the emergency department. METHODS We reviewed 34 adult patients with DVT diagnosed by sonography in an emergency department. Medical records including demographic data and sonography results were retrospectively reviewed and analyzed. RESULTS Mean age was 72.9 ± 16.5 years. Group I comprised 14 patients (41.2%) who had DVT in the popliteal and femoral veins. Group II comprised 8 patients (23.5%) who had DVT isolated to the popliteal vein and 12 patients (35.3%) who had DVT isolated to the femoral vein. Group I had a significantly higher non-compressibility ratio than Group II (93.4 ± 6.2% vs. 80.1 ± 19.2%, p < 0.05). The area under the receiver operating characteristic curve of the non-compressibility ratio between discriminating groups was 0.711 (95% confidence interval, 0.527-0.854; p < 0.05). The clinical prognostic score of Group I was significantly higher than that of Group II (6.2 ± 1.8 vs. 4.1 ± 2.6, p < 0.05). There was a significant positive correlation between the non-compressibility ratio of the thrombosed vein and the clinical prognostic score (p = 0.001). CONCLUSION The non-compressibility ratio of the thrombosed vein provides EPs with an objective test to evaluate the severity of DVT and to admit patients for consideration of adverse outcomes.