Isolated distal deep vein thrombosis (IDDVT) is a common subtype of deep vein thrombosis. Consensus guidelines provide conflicting recommendations for IDDVT management; some recommend anticoagulant treatment, while others suggest serial compression ultrasonography (CUS) monitoring for patients at “high risk” of proximal extension. The purpose of this study was to describe outcomes of serial CUS-monitored IDDVT and identify risk factors for thrombus extension into proximal veins or anticoagulant treatment initiation.
A retrospective descriptive study was conducted using electronic data from University of Utah Health. Adult subjects with objectively confirmed IDDVT managed using serial CUS surveillance were included. Subjects were followed for 30-days for occurrence of a composite outcome of proximal clot extension or anticoagulant treatment initiation. Descriptive statistics were used to summarize characteristics of the study population. Characteristics were compared across outcome groups using inferential statistics.
A total of 178 subjects were included, with 53 subjects (29.5%) experiencing the composite outcome. A prior history of VTE was significantly higher in those who experienced the composite outcome, or its separate components, than in those who did not.
Our results indicated that 7 out of 10 patients with IDDVT managed with serial CUS did not experience clot propagation or require anticoagulant treatment within 30 days of diagnosis. In lieu of evidence suggesting a clear benefit of anticoagulant treatment, serial CUS monitoring may be an appropriate management strategy for IDDVT. A history of VTE may be a useful surrogate marker for potentially unfavorable IDDVT outcomes.
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Great work, Alex! Poster looks great and your narration was really informative. What was one thing you learned about doing observational research during your project that you think will be useful to you as you move on to residency?
Thank you, Dr. Witt! One thing that I learned is that things may not go always go the way you expect in observational research. One thing that sticks out to me about this study was our original plan to study patients with orthopedic surgery-associated IDDVT – when we actually pulled the data, we found that there weren’t many patients who met those criteria. So with observational studies, when we don’t recruit a population that fits the study criteria, it’s important to keep an open mind and be ready to problem-solve and switch gears if needed. Thank you for your comment and question, and for all of your support with this research!
what a great project & poster! What 2 things did you learn about doing a project that are the most important to you?
Thank you, Dr. Nickman! One major thing that I learned about doing a project is to keep an open mind and manage expectations. I encountered several roadblocks during this research that required me to switch gears and do unexpected additional work. These things were disappointing at first, but putting in the work to fix the issues made my research stronger in the end. The other thing that I learned is how important it is to have a strong, supportive research team with a variety of skillsets. I could not have made this project happen without the help of my co-authors! My co-authors had knowledge and skills that would have taken me a long time to learn, which helped streamline the process significantly. Thank you for “visiting” my poster and for your question!
Wow interesting work. Thank you.
Awesome job, Alex!
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