Prevalence of deep vein thrombosis in suspected and proven pulmonary embolism: a meta-analysis

The purpose of this study was to determine the prevalence of lower extremit y deep venous thrombosis (DVT) in patients with suspected and proven pulmon ary embolism (PE). A meta-analysis was performed, based on literature from January 1983 to June 1997. Papers obtained from a computer-aided literature search were divided into studies with pulmonary angiography or ventilation -perfusion (V/Q) scintigraphy as the reference study. Our own observational data of the prevalence of DVT in 149 patients suspected of PE were also re ported. The estimated prevalence of DVT in patients with proven and suspect ed PE was calculated. In the 149 patients studied, the prevalence of DVT wa s 12% with suspected PE and 32% (95% confidence interval 20-46%) in patient s with proven PE. The individual studies showed a considerable heterogeneit y, the prevalence of DVT in proven PE ranged from 10 to 93%. The pooled est imate of the prevalence of DVT in patients suspected of PE, over all studie s, was 18% (95% confidence interval 15-20%). The DVT prevalence in proven P E was 36% (95% confidence interval 22-52%) in the angiography-based studies , and 45% (95% confidence interval 33-58%) in the V/Q scintigraphy-based st udies. In conclusion, the current meta-analysis shows that the prevalence o f DVT in suspected PE is approximately 18%, and in proven PE 36-45%.