UPPER EXTREMITY VERSUS LOWER-EXTREMITY DEEP VENOUS THROMBOSIS

BACKGROUND: In contrast to lower extremity deep venous thrombosis (LED VT), it is widely believed that upper extremity deep venous thrombosis (UEDVT) is associated with minimal morbidity or mortality. METHODS: I n an attempt to compare the two disease processes with respect to pulm onary embolism and mortality, we have reviewed records and performed i nterviews of 430 patients with LEDVT and 52 patients with UEDVT presen ting to our institution between January 1994 and June 1995. RESULTS: P ulmonary embolism was documented by ventilation/perfusion lung scan in 9 of 52 patients (17%) with UEDVT and 33 of 430 patients (8%) with LE DVT (P <0.05). Twenty-five of the UEDVT patients (48%) died within 6 m onths of the diagnosis of UEDVT. Conversely, 14 patients (13%) in the LEDVT group died within 6 months of the diagnosis of LEDVT (P <0.0002) . CONCLUSION: Contrary to previous reports, this study suggests that U EDVT is associated with a higher morbidity and mortality as compared w ith LEDVT. These data show that UEDVT has been an underrecognized pred ictor of morbidity and mortality. (C) 1999 by Excerpta Medica, Inc.