Skip to Main content Skip to Navigation
Master Thesis

Démarche diagnostique des suspicions de thromboses veineuses profondes des membres inférieurs : étude descriptive à propos de 214 cas au sein du service des urgences du Centre hospitalier d'Antibes

Abstract : Background: deep vein thrombosis (DVT) of the lower limb is potentially serious pathology found in general practice. Clinical signs offered not sure diagnosis. The Wells clinical probability score is used to establish an algorithm for a better diagnosis: D-dimer test and/or veinous ultrasound. Out-patient treatment of DVT accentuated in recent years by use of direct oral anticoagulants. Aim: observe and improve management of diagnostic suspicions of DVT. Methods: a retrospective descriptive study on the year 2018 concerning the patients admitted to the emergency department of Antibes Hospital and with suspicion TVP. Medical records were retained by « CIM-10 » coding with code M796 for pain at the limb, R232 for redness, R60 for localized edema. Results: 214 were analyzed. There were 141 women (66%) and the average age was 60.3 years. 103 patients (48%) had arrived on their own, 99 were referred by their general practicer (46%). The clinical reasons for emergency admission were pain in 74 patients (34.6%), redness in 72 patients (33.6%) and edema in 68 of them (31.8%). D-dimer was performed in 118 patients (55%), 79 were positive. Doppler was performed in 88 patients, DVT was found in 48 patients. 75 patients received a doppler prescription to be performed externally. Conclusion: our study confirms the clinical heterogeneity of DVT and the need for the development of a clinical probability score such as the Wells score to evaluate a diagnostic strategy based on an appropriate D-dimer test and the achievement of venous ultrasound. We propose to improve the outpatient management of suspicions of DVT by developing a practical diagnostic tool associating the different medical actors of Antibes region. Additional emergency consultation ranges have been created within vascular medicine outlets allowing emergency practicers to recall patients within 24 hours to ensure follow-up.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [2 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02454659
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Friday, January 24, 2020 - 4:50:06 PM
Last modification on : Wednesday, October 14, 2020 - 4:23:21 AM
Long-term archiving on: : Saturday, April 25, 2020 - 4:29:44 PM

File

2019NICEM092.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02454659, version 1

Citation

Grégory Sammelian. Démarche diagnostique des suspicions de thromboses veineuses profondes des membres inférieurs : étude descriptive à propos de 214 cas au sein du service des urgences du Centre hospitalier d'Antibes. Médecine humaine et pathologie. 2019. ⟨dumas-02454659⟩

Share

Metrics

Record views

51

Files downloads

27