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심부정맥혈전증으로 응급실에 내원한 환자에서 폐동맥색전증을 진단하기 위한 검사가 필요한가?
Medical : Do We Have to Check Pulmonary Thromboembolism in Patients with Deep Vein Thrombosis in Emergency Department?심부정맥혈전증으로 응급실에 내원한 환자에서 폐동맥색전증을 진단하기 위한 검사가 필요한가?
김태림 ( Taerim Kim ) , 유승목 ( Seung Mok Ryoo ) , 안신 ( Shin Ahn ) , 손창환 ( Chang Hwan Sohn ) , 서동우 ( Dong Woo Seo ) , 이재호 ( Jae Ho Lee ) , 이윤선 ( Yoon Seon Lee ) , 임경수 ( Kyung Soo Lim ) , 김원영 ( Won Young Kim )
UCI I410-ECN-0102-2016-510-000777926

Purpose: Deep vein thrombosis (DVT) is a risk factor of pulmonary thromboembolism (PTE), however it is not clear who should be evaluated for a PTE and a DVT at the same time. The purpose of this study is to determine the clinical characteristics of PTE in patients with DVT who visited the emergency department (ED). Methods: This was a retrospective cohort study of ED patients who visited with DVT and were simultaneously evaluated for a PTE from January 2012 to December 2013. We compared clinical characteristics between non-PTE and PTE patients with confirmed DVT in the ED. Results: Of these 166 patients, 96 patients (57.8%) were confirmed PTE by computed tomography. In multivariate analysis, patients with PTE had more systemic neoplasm (OR 2.03, 95% CI 1.04-3.93, p=0.037) and right heart strain pattern in electrocardiography (OR 5.29, 95% CI 1.71- 16.36, p=0.004) than patients without PTE. Femoral DVT was more likely in the non-PTE group (87.1% vs. 65.6%, p=0.002) and popliteal DVT was more likely in the PTE group (62.9% vs. 80.2%, p=0.013). However the number of DVT sites including both femoral and popliteal vein was not statistically different. Conclusion: In patients with systemic neoplasm or right heart strain patterns in electrocardiography, simultaneous PTE evaluation may be required in patients with DVT.

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