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Hilde Skuterud Wik
Oslo Universitetssykehus
Corresponding Author
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Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT.
Methods During 2006-09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (>1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression.
Results 88 patients (52%) were included 8-10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93-0.99), and 1.23 (95% CI, 1.02-1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments.
Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.
Keywords
Comorbidity, deep vein thrombosis, post-thrombotic syndrome, predictors, venous insufficiency
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at Thrombosis Journal.
No community comments so far
Editorial decision: Accept
On 15 Dec, 2020
Review #2 received
Received 14 Dec, 2020
Reviewer #2 agreed
On 02 Dec, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Reviewer #1 agreed
On 26 Nov, 2020
Review #1 received
Received 26 Nov, 2020
Editor assigned
On 21 Nov, 2020
Submission checks complete
On 21 Nov, 2020
Editor invited
On 21 Nov, 2020
No comments provided
Editorial decision: Major revision
On 07 Oct, 2020
Review #2 received
Received 03 Oct, 2020
Review #1 received
Received 23 Sep, 2020
Reviewer #1 agreed
On 21 Sep, 2020
Reviewer #2 agreed
On 21 Sep, 2020
Reviewers invited
Invitations sent on 02 Sep, 2020
Editor assigned
On 01 Sep, 2020
Submission checks complete
On 31 Aug, 2020
Editor invited
On 31 Aug, 2020
Version 1
Posted 23 May, 2020
No comments provided
Editorial decision: Major revision
On 02 Aug, 2020
Review #1 received
Received 20 Jul, 2020
Reviewer #1 agreed
On 06 Jul, 2020
Editor assigned
On 18 May, 2020
Reviewers invited
Invitations sent on 18 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
First submitted
On 15 May, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Clinical Pharmacology
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A new preprint design is coming!
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See the published version of this preprint at Thrombosis Journal.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Hilde Skuterud Wik
Oslo Universitetssykehus
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Thrombosis Journal.
No community comments so far
Editorial decision: Accept
On 15 Dec, 2020
Review #2 received
Received 14 Dec, 2020
Reviewer #2 agreed
On 02 Dec, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Reviewer #1 agreed
On 26 Nov, 2020
Review #1 received
Received 26 Nov, 2020
Editor assigned
On 21 Nov, 2020
Submission checks complete
On 21 Nov, 2020
Editor invited
On 21 Nov, 2020
No comments provided
Editorial decision: Major revision
On 07 Oct, 2020
Review #2 received
Received 03 Oct, 2020
Review #1 received
Received 23 Sep, 2020
Reviewer #1 agreed
On 21 Sep, 2020
Reviewer #2 agreed
On 21 Sep, 2020
Reviewers invited
Invitations sent on 02 Sep, 2020
Editor assigned
On 01 Sep, 2020
Submission checks complete
On 31 Aug, 2020
Editor invited
On 31 Aug, 2020
Version 1
Posted 23 May, 2020
No comments provided
Editorial decision: Major revision
On 02 Aug, 2020
Review #1 received
Received 20 Jul, 2020
Reviewer #1 agreed
On 06 Jul, 2020
Editor assigned
On 18 May, 2020
Reviewers invited
Invitations sent on 18 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
First submitted
On 15 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Clinical Pharmacology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Thrombosis Journal.
Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT.
Methods During 2006-09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (>1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression.
Results 88 patients (52%) were included 8-10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93-0.99), and 1.23 (95% CI, 1.02-1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments.
Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.
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