Follow-up study of patients with clinically suspected deep venous thrombosis and a normal venogram.

Abstract

OBJECTIVES: To evaluate the clinical course in patients with clinically suspected deep venous thrombosis (DVT) of the leg and a normal venogram. DESIGN: Prospective study over 15 months with a follow-up of 4-12 (median 8.6) months after a normal venogram. A questionnaire survey was performed at follow-up. Information from general practitioners and medical records was reviewed. An alternative diagnosis was established at presentation and at the time of follow-up. SETTING: The Department of Internal Medicine in a Danish university hospital. SUBJECTS: A total of 133 consecutive out-patients referred with clinical suspicion of DVT and a normal venogram. MAIN OUTCOME MEASURES: The state of symptoms at follow-up. The frequency of referrals to hospitals and contacts with general practitioners or medical specialists in the follow-up period. Clinical diagnoses provided at presentation and at follow-up. RESULTS: The follow-up response rate was 78% (n = 104). The symptoms were still present at follow-up in 53 (51%) patients. More than half of the patients had been referred to medical facilities for the same disorder. Diagnoses could be established in 93 (70%) of the 133 patients at presentation and in 119 (89%) at follow-up. CONCLUSIONS: The majority of patients with clinical signs and symptoms of a DVT and a normal venogram may require a follow-up surveillance programme to ensure correct diagnosis and adequate treatment. Further studies are recommended to confirm our results and to assess the cost-effectiveness.