急诊医师与放射科医师两点压缩超声检测深静脉血栓的比较

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL Ibnosina Journal of Medicine and Biomedical Sciences Pub Date : 2023-04-04 DOI:10.1055/s-0043-1762938
Göknur Öztürk, F. Selvi, G. Yıldız, S. Atay, Bora Baltacıoğlu, C. Bedel
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引用次数: 0

摘要

摘要简介 静脉血栓栓塞症(VTE)是一种严重的凝血障碍,包括深静脉血栓形成(DVT)和肺栓塞,是导致住院和死亡的重要原因。本研究旨在评估急诊医生和放射科医生在急诊科使用两点压缩超声(USG)方法诊断DVT的依从性。患者和方法 这项前瞻性横断面研究于2022年2月至7月在一所三级大学医院的急诊医学诊所进行,患者被认为患有DVT并有下肢静脉USG指征。研究表格中记录了患者的人口学信息、Wells评分中使用的临床标志物以及急诊医生和放射科医生的USG结果 共有400名患者被纳入研究。研究患者的平均年龄为59.8岁 ± 18.0岁和54.4%(n = 217例)患者为男性。Wells评分为2分或以下的患者和Wells评分高于2分的患者DVT的发生率存在显著差异(n = 67,21.8%对n = 41.47.1%;p < 0.001)。关于急诊医生和放射科医生评估DVT的观察者间一致性,右股静脉的kappa值为0.81(95%置信区间[CI]:0.71–0.91),左股静脉为0.89(95%可信区间:0.81–0.97)。发现所有下肢静脉USG的值为0.81(95%CI:0.76–0.86)。结论 急诊科和放射科医生在诊断DVT伴USG方面有很好的一致性。
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Comparison of Two-Point Compression Ultrasonography Performed by Emergency Medicine Doctors and Radiologists in Detection of Deep Vein Thrombosis
Abstract Introduction  Venous thromboembolism (VTE) is a serious coagulation disorder that includes deep vein thrombosis (DVT) and pulmonary embolism and is an important cause of hospitalization and death. This study aimed to evaluate the compliance of the emergency doctor and radiologist in diagnosing DVT in the emergency department using the two-point compression ultrasonography (USG) method. Patients and Methods  This prospective cross-sectional study was performed between February and July 2022 in the Emergency Medicine Clinic of a tertiary university hospital with patients who were thought to have DVT and had lower extremity venous USG indication. Demographic information of patients, clinical markers used in the Wells score, and USG results of the emergency doctors and radiologists were recorded in the study form. Results  A total of 400 patients were included in the study. The mean age of the study patients was 59.8 ± 18.0 years, and 54.4% ( n  = 217) of the patients were male. There was a significant difference in the incidence of DVT between those with a Wells score of 2 or less and those above 2 ( n  = 67, 21.8% vs. n  = 41, 47.1%; p  < 0.001). Regarding interobserver agreement in the evaluation of DVT by emergency medicine doctor and radiologist, kappa values were 0.81 (95% confidence interval [CI]: 0.71–0.91) for the right femoral vein, 0.89 (95% CI: 0.81–0.97) for the left femoral vein. It was found to be 0.81 (95% CI: 0.76–0.86) for all lower extremity vein USGs. Conclusions  There is a very good level of agreement between the emergency department and the radiologist in diagnosing DVT with USG.
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