Point-of-Care Ultrasound stratified by the Wells Score for the diagnosis of proximal deep vein thrombosis: A Prospective Study

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dc.article.number100187
dc.catalogadoraba
dc.contributor.authorRojas Muñoz, Nicolás
dc.contributor.authorClausdorff Fiedler, Hans Jurgen
dc.contributor.authorRiquelme Morales, Felipe Ignacio
dc.contributor.authorVidal Zamorano, Victor Alejandro
dc.contributor.authorSeydewitz Osses, María Francisca
dc.contributor.authorRivera Gonzalez, Sofía Viviana
dc.contributor.authorBasaure Verdejo, Carlos Eugenio
dc.date.accessioned2025-08-01T16:47:20Z
dc.date.available2025-08-01T16:47:20Z
dc.date.issued2025
dc.description.abstractBackground Deep vein thrombosis (DVT) affects 1 in 1000 people, with complications associated both in under and over diagnosis. Duplex ultrasound is the gold standard but its use in emergency settings is limited. Two-point Point-of-Care ultrasound protocol performed by emergency physicians can foster its diagnosis. However, 6 % of cases can be missed and its performance stratified by clinical pre-test probability is unknown. Objective To evaluate the diagnostic performance of an extended compression ultrasound (ECUS) protocol performed by emergency physicians when stratified by Wells score. Methods We conducted a prospective diagnostic accuracy study. Adult patients (≥18 years) with suspected DVT were stratified by Wells score (low, intermediate, high risk) and underwent ECUS by trained emergency physicians or residents. Results were compared to complete duplex ultrasound (CDUS) performed by radiologists within 24 h. Results Among 194 patients analyzed (54 % female, mean age 61 ± 18 years), the overall prevalence of proximal DVT was 17 %. The ECUS protocol demonstrated a global sensitivity of 97 % (95 % CI: 84.2–99.9), specificity of 94.4 % (95 % CI: 89.7–97.4), positive predictive value of 78.6 % (95 % CI: 63.2–89.4), and negative predictive value of 99.3 % (95 % CI: 96.4–100). In the low-risk group, sensitivity was 100 % (95 % CI: 29.2–100) with a negative predictive value of 100 % (95 % CI: 90.7–100). Conclusion The combined use of Wells score stratification and ECUS can reliably exclude proximal DVT in low and intermediate-risk patients, potentially optimizing emergency department resources and facilitating timely clinical decisions. In low-risk patients, this strategy may yield results comparable to comprehensive Doppler ultrasound.
dc.fechaingreso.objetodigital2025-08-01
dc.format.extent5 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1016/j.jemrpt.2025.100187
dc.identifier.eissn2773-2320
dc.identifier.urihttps://doi.org/10.1016/j.jemrpt.2025.100187
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/105096
dc.information.autorucEscuela de Medicina; Clausdorff Fiedler, Hans Jurgen; 0000-0002-0571-7815; 172140
dc.information.autorucEscuela de Medicina; Riquelme Morales, Felipe Ignacio; S/I; 187228
dc.information.autorucEscuela de Medicina; Vidal Zamorano, Victor Alejandro; S/I; 1052519
dc.information.autorucEscuela de Medicina; Seydewitz Osses, María Francisca; S/I; 234432
dc.information.autorucEscuela de Medicina; Rivera Gonzalez, Sofía Viviana; S/I; 223775
dc.information.autorucEscuela de Medicina; Basaure Verdejo, Carlos Eugenio; S/I; 1012425
dc.issue.numero3
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaJEM Reports
dc.rightsacceso abierto
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectPoint-of-care ultrasound
dc.subjectDeep vein thrombosis
dc.subjectWells-score
dc.subjectDiagnosis
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titlePoint-of-Care Ultrasound stratified by the Wells Score for the diagnosis of proximal deep vein thrombosis: A Prospective Study
dc.typeartículo
dc.volumen4
sipa.codpersvinculados172140
sipa.codpersvinculados187228
sipa.codpersvinculados1052519
sipa.codpersvinculados234432
sipa.codpersvinculados223775
sipa.codpersvinculados1012425
sipa.trazabilidadORCID;2025-07-28
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