Investigation of the relationship between the localization of lower extremity deep vein thrombosis detected in the emergency department and occurance of concurrent or recent pulmonary embolism

Objective: Pulmonary embolism is a preventable disease that has high mortality and is sometimes difficult to diagnose. It mostly occurs due to deep vein thrombosis (DVT). The aim of this study is to conduct a retrospective statistical study on which vein in the lower extremity deep venous thrombosis increases the risk of recent pulmonary embolism more and if a significant difference is detected in the result, the aim is to be more sensitive in terms of pulmonary embolism examination in patients with deep vein thrombosis in this vein if they are accompanied by possible pulmonary embolism symptoms or risk factors. Materials and Methods: This study was conducted retrospectively at Istanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Emergency Medicine, after the ethics committee decision. The study was conducted with data obtained from the Hospital Information Management System and a 3-year retrospective review was conducted. Statistical distribution of DVT localizations of patients diagnosed with pulmonary embolism within the following 1 month was investigated in the group of patients with deep vein thrombus that was not evaluated as chronic in the lower extremity venous Doppler ultrasonography requested from the emergency department. Results: The most common thrombus localizations in DVT patients were popliteal vein and superficial femoral vein. It was determined that the most common accompanying diseases in these patients were malignancy, HT and DM. It was observed that the 28-day mortality rate of DVT patients was 4.1%, while the 6-month mortality was 21.2% and 11.8% of all DVT patients were diagnosed with pulmonary embolism. Among the comorbidities, malignancy and coronary artery disease were significant in terms of 28-day mortality risk, while malignancy and COPD were significant in terms of 6-month mortality risk. It was determined that the most common DVT sites in patients who developed pulmonary embolism were the popliteal vein with 85% and the common femoral vein with 45%. Conclusion: It has been shown that comorbidities, advanced age, high d-dimer levels, and pulmonary embolism accompanying this diagnosis have statistically significant effects on prognosis and mortality in patients who present with DVT symptoms and receive this diagnosis. Although there were no statistically significant results, it was observed that some DVT localizations were more common in the pulmonary embolism group than in the general DVT group. These findings may have an important place in the diagnosis-treatment-clinical follow-up process and can be taken into consideration in decision-making processes. Thus, the outcome of venous thromboembolism patients can be improved. Keywords : Deep Vein Thrombosis, Comorbidity, Mortality, Pulmonary Embolism, Emergency Room