Background: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are regarded as 2 distinct clinical presentations of the same illness. Up to 90% of symptomatic PEs are caused by thrombi in the venous system of the lower extremities. There is a great deal of uncertainty regarding the precise frequency of DVT in individuals with PE and the clinical importance of concurrent DVT. Objective: The aim of the current study was to evaluate the prevalence and prognostic significance of DVT in patients with PE.
Patients and methods: A retrospective study included 100 patients with confirmed PE. CT pulmonary angiography (CTPA) was used to diagnose all PEs. Using duplex ultrasonography, all patients were evaluated for the existence of DVT in the lower or upper extremities. Patients were classified into concomitant DVT and non-DVT groups.
Results: DVT was detected in 44% of PE cases (16 of them had subclinical DVT without evident symptoms “36.4% of DVT cases"). Proximal lower limb DVT was found in 36 patients and 6 cases suffered distal lower limb DVT. Upper limb DVT was shown in only 2 cases. Bilateral DVT was found in only 4 cases. Wells and modified Wells scores were significantly different among the 2 groups, where DVT confirmed cases presented more with likely or high-risk cases than DVT negative group. Mortality was proved to be insignificantly different between both groups with 22.3% mortality in DVT positive cases and 25% mortality in DVT negative cases, with overall mortality of 24%.
Conclusions: Nearly half of PE cases had concomitant DVT and that associated DVT had no effect on mortality. Post-operative period and cancer are two comorbidities that could be risk factors for PE without DVT.