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Early diagnosis of deep vein thrombosis following total hip replacement using impedance plethysmography: advantages and limitations of this approach.
Ital J Orthop Traumatol. 1992; 18(2):253-9.IJ

Abstract

Early diagnosis of deep vein thrombosis (DVT) following total hip replacement is of fundamental importance given the particularly high incidence of thromboembolic complications and the limited effectiveness of available preventive measures. The authors report the results of postoperative monitoring of the lower limbs using impedance plethysmography (IPG). The validity of the computerized plethysmograph used in this study has been confirmed by previous clinical studies, in which this instrument demonstrated high sensitivity and specificity of diagnosis of deep vein thrombosis in the symptomatic patient. In the present study, however, the instrument is applied to a group of mostly asymptomatic patients, many of whom have non-occlusive DVT. One hundred thirty-two patients underwent IPG both one the day before surgery and on the seventh day after surgery. The postoperative IPG was positive in seven asymptomatic patients (5.3%). Proximal DVT was confirmed by phlebography in five patients (3.7%) and found to be absent in two patients (false positives: 1.5%), for a positive predictive value of 71%. IPG also found proximal DVT to be absent in three patients with postoperative signs and/or symptoms compatible with a thrombotic complication in the lower limbs. The character of the study did not permit collection of data as to IPG sensitivity in the asymptomatic patient, which is presumably quite lower than in the symptomatic patient. Therefore, phlebography remains the most reliable test for diagnosis of asymptomatic DVT. However, systematic monitoring by phlebography is not feasible for logistic, economic, and ethical reasons. Postoperative use of IPG may at least partially reduce the risks connected with thromboembolic complications.

Authors+Show Affiliations

Divisione di Ortopedia e Traumatologia, Università di Pavia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1289291

Citation

Domenella, G, et al. "Early Diagnosis of Deep Vein Thrombosis Following Total Hip Replacement Using Impedance Plethysmography: Advantages and Limitations of This Approach." Italian Journal of Orthopaedics and Traumatology, vol. 18, no. 2, 1992, pp. 253-9.
Domenella G, Ghidini M, Samaden A, et al. Early diagnosis of deep vein thrombosis following total hip replacement using impedance plethysmography: advantages and limitations of this approach. Ital J Orthop Traumatol. 1992;18(2):253-9.
Domenella, G., Ghidini, M., Samaden, A., Carbone, S., Siragusa, S., Piovella, F., Passera, R., Bertolotti, P., & Ascari, E. (1992). Early diagnosis of deep vein thrombosis following total hip replacement using impedance plethysmography: advantages and limitations of this approach. Italian Journal of Orthopaedics and Traumatology, 18(2), 253-9.
Domenella G, et al. Early Diagnosis of Deep Vein Thrombosis Following Total Hip Replacement Using Impedance Plethysmography: Advantages and Limitations of This Approach. Ital J Orthop Traumatol. 1992;18(2):253-9. PubMed PMID: 1289291.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early diagnosis of deep vein thrombosis following total hip replacement using impedance plethysmography: advantages and limitations of this approach. AU - Domenella,G, AU - Ghidini,M, AU - Samaden,A, AU - Carbone,S, AU - Siragusa,S, AU - Piovella,F, AU - Passera,R, AU - Bertolotti,P, AU - Ascari,E, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 253 EP - 9 JF - Italian journal of orthopaedics and traumatology JO - Ital J Orthop Traumatol VL - 18 IS - 2 N2 - Early diagnosis of deep vein thrombosis (DVT) following total hip replacement is of fundamental importance given the particularly high incidence of thromboembolic complications and the limited effectiveness of available preventive measures. The authors report the results of postoperative monitoring of the lower limbs using impedance plethysmography (IPG). The validity of the computerized plethysmograph used in this study has been confirmed by previous clinical studies, in which this instrument demonstrated high sensitivity and specificity of diagnosis of deep vein thrombosis in the symptomatic patient. In the present study, however, the instrument is applied to a group of mostly asymptomatic patients, many of whom have non-occlusive DVT. One hundred thirty-two patients underwent IPG both one the day before surgery and on the seventh day after surgery. The postoperative IPG was positive in seven asymptomatic patients (5.3%). Proximal DVT was confirmed by phlebography in five patients (3.7%) and found to be absent in two patients (false positives: 1.5%), for a positive predictive value of 71%. IPG also found proximal DVT to be absent in three patients with postoperative signs and/or symptoms compatible with a thrombotic complication in the lower limbs. The character of the study did not permit collection of data as to IPG sensitivity in the asymptomatic patient, which is presumably quite lower than in the symptomatic patient. Therefore, phlebography remains the most reliable test for diagnosis of asymptomatic DVT. However, systematic monitoring by phlebography is not feasible for logistic, economic, and ethical reasons. Postoperative use of IPG may at least partially reduce the risks connected with thromboembolic complications. SN - 0390-5489 UR - https://www.unboundmedicine.com/medline/citation/1289291/Early_diagnosis_of_deep_vein_thrombosis_following_total_hip_replacement_using_impedance_plethysmography:_advantages_and_limitations_of_this_approach_ L2 - https://www.diseaseinfosearch.org/result/7087 DB - PRIME DP - Unbound Medicine ER -