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The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients

AIM: Deep vein thrombosis (DVT) is considered a possible source of non‐infectious, non‐central fever in the intensive care unit (ICU). In the neurocritically ill, it is unknown whether lower extremity venous Doppler ultrasonography (LEVDUS) for DVT in the setting of fever leads to a higher detection...

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Autores principales: Henson, Theresa, Velasquez, Ricardo, Martin, Alvaro, Kozlova, Natalya, Chandy, Dipak, Epelbaum, Oleg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10475977/
https://www.ncbi.nlm.nih.gov/pubmed/37670903
http://dx.doi.org/10.1002/ams2.889
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author Henson, Theresa
Velasquez, Ricardo
Martin, Alvaro
Kozlova, Natalya
Chandy, Dipak
Epelbaum, Oleg
author_facet Henson, Theresa
Velasquez, Ricardo
Martin, Alvaro
Kozlova, Natalya
Chandy, Dipak
Epelbaum, Oleg
author_sort Henson, Theresa
collection PubMed
description AIM: Deep vein thrombosis (DVT) is considered a possible source of non‐infectious, non‐central fever in the intensive care unit (ICU). In the neurocritically ill, it is unknown whether lower extremity venous Doppler ultrasonography (LEVDUS) for DVT in the setting of fever leads to a higher detection rate than the baseline detection rate of DVT in this population. The aim of this study was to compare the DVT detection rate of LEVDUS performed for the indication of fever to LEVDUS performed for other indications in a neurosciences ICU. METHODS: Requisition forms for all LEVDUS performed in a referral neurosciences ICU were reviewed and separated into those with “fever” as the stated reason for request and those with other stated reasons. The DVT detection rate was compared between these two categories of indications. RESULTS: Five hundred eleven LEVDUS were analyzed, of which 422 had been ordered for indications other than fever. Sixteen of these tests were positive, a detection rate of 3.8%. The remaining 89 LEVDUS had “fever” as the ordering indication. Six of these tests were positive for DVT, a detection rate of 6.7%. The likelihood of positivity of a test obtained as part of fever evaluation relative to one obtained for non‐fever indications was not significantly different (OR, 1.83; 95% CI, 0.570–5.11; P = 0.246). CONCLUSION: LEVDUS triggered by fever detected DVT at a numerically, but not statistically significantly higher rate than did LEVDUS performed for other indications in a neurocritically ill population. More rigorous investigation of this question is needed.
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spelling pubmed-104759772023-09-05 The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients Henson, Theresa Velasquez, Ricardo Martin, Alvaro Kozlova, Natalya Chandy, Dipak Epelbaum, Oleg Acute Med Surg Brief Communication AIM: Deep vein thrombosis (DVT) is considered a possible source of non‐infectious, non‐central fever in the intensive care unit (ICU). In the neurocritically ill, it is unknown whether lower extremity venous Doppler ultrasonography (LEVDUS) for DVT in the setting of fever leads to a higher detection rate than the baseline detection rate of DVT in this population. The aim of this study was to compare the DVT detection rate of LEVDUS performed for the indication of fever to LEVDUS performed for other indications in a neurosciences ICU. METHODS: Requisition forms for all LEVDUS performed in a referral neurosciences ICU were reviewed and separated into those with “fever” as the stated reason for request and those with other stated reasons. The DVT detection rate was compared between these two categories of indications. RESULTS: Five hundred eleven LEVDUS were analyzed, of which 422 had been ordered for indications other than fever. Sixteen of these tests were positive, a detection rate of 3.8%. The remaining 89 LEVDUS had “fever” as the ordering indication. Six of these tests were positive for DVT, a detection rate of 6.7%. The likelihood of positivity of a test obtained as part of fever evaluation relative to one obtained for non‐fever indications was not significantly different (OR, 1.83; 95% CI, 0.570–5.11; P = 0.246). CONCLUSION: LEVDUS triggered by fever detected DVT at a numerically, but not statistically significantly higher rate than did LEVDUS performed for other indications in a neurocritically ill population. More rigorous investigation of this question is needed. John Wiley and Sons Inc. 2023-09-04 /pmc/articles/PMC10475977/ /pubmed/37670903 http://dx.doi.org/10.1002/ams2.889 Text en © 2023 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Brief Communication
Henson, Theresa
Velasquez, Ricardo
Martin, Alvaro
Kozlova, Natalya
Chandy, Dipak
Epelbaum, Oleg
The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients
title The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients
title_full The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients
title_fullStr The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients
title_full_unstemmed The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients
title_short The impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients
title_sort impact of fever as a testing indication on the detection rate of deep vein thrombosis in neurocritically ill patients
topic Brief Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10475977/
https://www.ncbi.nlm.nih.gov/pubmed/37670903
http://dx.doi.org/10.1002/ams2.889
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