EPIDEMIOLOGIC CHARACTERISTICS, MANAGEMENT, AND OUTCOME OF DEEP VENOUSTHROMBOSIS IN A TERTIARY-CARE HOSPITAL - THE BRIGHAM-AND-WOMENS-HOSPITAL DVT REGISTRY

Entry into clinical trials of treatment for deep venous thrombosis (DV T) involves a screening process that excludes many patients with this condition, Therefore, to obtain a profile of patients with DVT that re flects actual day-to-day clinical practice, we initiated a prospective registry of 150 consecutive patients with DVT at Brigham and Women's Hospital, Boston, We reviewed the medical records of all patients who received a diagnosis of DVT from November 1, 1994 through March 31, 19 95 and did not exclude any patients, Of the 150 patients, 120 (80%) we re symptomatic and 30 (20%) were asymptomatic, Frequent baseline chara cteristics included surgery within the preceding 6 months (47%), cance r (26%), and previous venous thromboembolism (23%), DVT was diagnosed by ultrasonography (n = 145), contrast venography (n = 3), or clinical evaluation (in 2 patients who had technically unsatisfactory ultrasou nd results). Overall, 133 (89%) patients received anticoagulation; 5 ( 3%) received thrombolysis; and 27 (18%) underwent placement of an infe rior vena caval filter. In 3 patients major hemorrhage developed from anticoagulation or thrombolysis. The 3-month mortality rate was 19%, i ncluding 10 patients who died during the index hospitalization. In no case was pulmonary embolism thought to be the cause of death, Ten pati ents had recurrent venous thrombosis during the initial 3 months after diagnosis, The most surprising findings in the DVT registry were the high rates of cancer and surgery, the high rate of filter placement, a nd the high mortality rate, These registry results differ substantiall y from findings in randomized controlled trials of DVT treatment.