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ENGLISH ABSTRACT
JOURNAL ARTICLE
OBSERVATIONAL STUDY
[Usefulness of assessing hydration status in elderly patients over 70 years with suspected deep vein thrombosis].
La Revue de Médecine Interne 2015 June
INTRODUCTION: Venous thromboembolism and dehydration are frequent conditions in elderly. The objective of this study was to assess the prevalence of dehydration in patients aged over 70 years suspected of deep vein thrombosis (DVT).
METHODS: This is a prospective observational study that included patients aged over 70 years and suspected of deep vein thrombosis. Clinical and biological dehydration was diagnosed on the presence of a skin fold, a weight loss≥5%, a thirst, a plasmatic osmolality>295 mOsm/L or blood urea nitrogen/creatinine ratio>20.
RESULTS: One hundred and forty-four patients (mean age 81.8±5.8 years) were included. A diagnosis of DVT was retained in 97 patients. Clinical dehydration was not more frequent in the DVT+ group (37.2% vs 35.1%). At baseline, 69.1% of DVT+ patients and 53.2% of DVT- patients had a plasma osmolality greater than 295 mosm/L (NS). BUN/creatinine ratio greater than 20 was found in 58.8% of DVT+ patients and 72.3% of DVT- patients (NS). Clinical and biological dehydration was present in 28.6% of DVT+ patients and in 33.3% of DVT- patients (NS). The positive predictive value of the Wells score≥3 was 86.5%, and negative predictive value of a Wells score≤0 was 85%.
CONCLUSION: The presence of dehydration does not appear predictive of the occurrence of DVT and does not influence the statistical performance of the Wells score in elderly patients.
METHODS: This is a prospective observational study that included patients aged over 70 years and suspected of deep vein thrombosis. Clinical and biological dehydration was diagnosed on the presence of a skin fold, a weight loss≥5%, a thirst, a plasmatic osmolality>295 mOsm/L or blood urea nitrogen/creatinine ratio>20.
RESULTS: One hundred and forty-four patients (mean age 81.8±5.8 years) were included. A diagnosis of DVT was retained in 97 patients. Clinical dehydration was not more frequent in the DVT+ group (37.2% vs 35.1%). At baseline, 69.1% of DVT+ patients and 53.2% of DVT- patients had a plasma osmolality greater than 295 mosm/L (NS). BUN/creatinine ratio greater than 20 was found in 58.8% of DVT+ patients and 72.3% of DVT- patients (NS). Clinical and biological dehydration was present in 28.6% of DVT+ patients and in 33.3% of DVT- patients (NS). The positive predictive value of the Wells score≥3 was 86.5%, and negative predictive value of a Wells score≤0 was 85%.
CONCLUSION: The presence of dehydration does not appear predictive of the occurrence of DVT and does not influence the statistical performance of the Wells score in elderly patients.
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