Is colour Doppler ultrasound a sensitive screening method in diagnosing deep vein thrombosis after hip surgery?
Comparative study published in Thromb Haemost (1996)
Abstract
Patients under going orthopedic surgery are at high risk of developing deep vein thrombosis. One hundred and thirty-eight consecutive patients undergoing total hip replacement or hip fracture surgery were included in this study. They were surveilled with colour Doppler ultrasound (CDU) and bilateral ascending contrast phlebography. The prevalence of proximal and distal DVT in this study was 5.8% and 20.3% respectively. CDU has a satisfactory sensitivity in patients with symptomatic deep vein thrombosis, especially in the proximal region. These results could not be confirmed in the present study of asymptomatic patients. The sensitivity was 62.5% (95% confidence interval: C.I. 24-91%) and the specificity 99.6% (C.I. 98-100%) for proximal DVT; 53.6% (C.I. 34-73%) and 98% (C.I. 96-99%) respectively for distal thrombi. the overall sensitivity was 58.1% (C.I. 39-75%) and the specificity 98% (C.I. 96-99%). The positive predictive value was 83.3% (C.I. 36-99%) and 75% (C.I. 51-91%) for proximal and distal DVT respectively. The negative predictive value was 98.9% (C.I. 98-100%) and 94.9% (C.I. 92-98%) for proximal and distal DVT respectively. The results of this study showed that even with a highly specialised and experienced investigator the sensitivity of CDU was too low to make it suitable for screening purposes in a high risk surgical population.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
138 patients with total hip replacement; CDU sensitivity 58.1% vs phlebography; insufficient sensitivity for routine asymptomatic screening despite use of hirudin DVT prophylaxis.
Why This Matters for Hirudotherapy
This study evaluated color Doppler ultrasound (CDU) as a screening tool for deep vein thrombosis in 138 consecutive patients undergoing total hip replacement or hip fracture surgery, comparing it with bilateral ascending contrast phlebography. It reported overall sensitivity of 58.1% and specificity of 98%, concluding that CDU sensitivity was too low for screening in this high-risk surgical population. Its relevance to ASH is only indirect: the study concerns diagnostic imaging after hip surgery and does not investigate hirudotherapy, the leech secretome, or any anticoagulant intervention. No leech-related findings, conclusions, or agents are discussed in the abstract.
Citation
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