Resumo

BECKER, Carlos A. et al. Prospective Registry of Diagnostic Strategies Applied on Venous Thromboembolism in Intensive Care Units of Santa Fe. Rev. argent. cardiol. [online]. 2014, vol.82, n.3, pp.218-224. ISSN 1850-3748.

Introduction Venous thromboembolism is a common disease with high morbidity and mortality which can be reduced drastically with early diagnosis and treatment. The diagnosis of venous thromboembolism faces two difficulties: the low clinical suspicion and the complexity of the technical resources required which are not always available, making it difficult to apply the algorithms recommended by the guidelines. Objectives The evaluate the diagnostic strategies used by the intensive care units in the city of Santa Fe when venous thromboembolism suspected, and to identify if any diagnostic algorithm is applied and the degree of final uncertain diagnosis. Methods A prospective multicenter and observational registry of patients hospitalized with suspicion of venous thromboembolism [(deep venous thrombosis (DVT) and/or pulmonary embolism (PE)] was elaborated by all the adult intensive care units. Results Over a three and a half-month period, 3042 patients were hospitalized in the 19 intensive care units of the city. Venous thromboembolism was suspected in 83 patients (50 PE, 10 DVT and 23 PE + DVT). The diagnosis was confirmed in 25 (30.1%), was ruled out in 33 (39.8%) and remained uncertain in 25 (30.1%). The final uncertain diagnosis was 25.7% in private centers and 66.6% in public hospitals. The index of suspicion was 2.7% (range 0.9% to 8.8%). The algorithms recommended by guidelines were not systematically used. Conclusions This registry showed a low global index of suspicion for venous thromboembolism, the algorithms recommended by guidelines were not used and the final uncertain diagnosis was 30.1%.

Palavras-chave : Thromboembolism; Diagnosis; Epidemiology.

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