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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB1027 - Delayed diagnosis and treatment of deep vein thrombosis-an underrecognized factor for its related complications?

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition

      Co-Author(s)

    • Kochawan Boonyawat, MD

      Assistant Professor
      Ramathibodi Hospital
      Bangkok, Krung Thep, Thailand

      • Co-Author(s)

    • KP

      Kanokporn Puttarak

      Instructor
      Ramathibodi Hospital
      Bangkok, Krung Thep, Thailand

      • Presenting Author(s)

    • Pantep Angchaisuksiri, MD

      Professor of Medicine
      Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
      Bangkok, Krung Thep, Thailand

    Background: Rapid diagnosis and treatment of deep vein thrombosis (DVT) reduce morbidity and mortality.

    Aims: The aims of this study were to investigate the diagnostic time, time to treatment, and complications associated with the delayed diagnosis of DVT.

    Methods: We retrospectively investigated 110 patients who were diagnosed with proximal DVT in outpatient clinics in a single academic centre in Thailand from January 2019 to September 2020. We recorded demographic data, clinical presentations, time to initial imaging ordered by a clinician, time to diagnostic imaging (ultrasound of the legs), time to treatment, and complications including death, pulmonary embolism, recurrent DVT, thrombus resolution at 3 months after the diagnosis of DVT.

    Results: Of all 110 patients, 42 (38.2%) were male. Median age (interquartile range, IQR) was 68.5 (58-80) years. The median (IQR) time to diagnostic imaging was 7 days (2-27). The median (IQR) interval from the first OPD visit to the initiation of treatment was 14 days (3-31) (Figure 1). The delayed diagnosis (more than 7 days from the first OPD visit to diagnostic imaging) was observed in 54 (49%) patients with DVT. The delay in treatment (more than 7 days from first OPD visit to treatment) was observed in 67 (60.9%) patients. The maximum time to treatment was 160 days. Death and pulmonary embolism occurred in 9% and 33% in patients with delayed treatment while they occurred in 5% and 20% of those with early treatment, respectively. No recurrent DVT was observed. Among 25 patients who had follow-up imaging, residual thrombus occurred in 71% of patients with delayed treatment while it occurred in 63% of those with early treatment. (Table 1)

    Conclusion(s): Half of the proximal DVT patients had delayed diagnosis and treatment resulting poorer outcomes. Importance of early diagnosis and treatment of DVT should be raised among physicians and improvement strategies are warranted.