Imperial College London

Dr Benjamin Mullish

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

NIHR Clinical Lecturer
 
 
 
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Contact

 

b.mullish

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@inproceedings{Emmanuel:2014:10.1016/j.jval.2014.03.887,
author = {Emmanuel, J and Wells, M and Raichura, H and Gunawan, A and McLoughlin, T and Mullish, BH and Wilson, L},
doi = {10.1016/j.jval.2014.03.887},
pages = {A152--A152},
title = {Low Incidence of Venous Thromboembolism in Mobile Populations},
url = {http://dx.doi.org/10.1016/j.jval.2014.03.887},
year = {2014}
}

RIS format (EndNote, RefMan)

TY  - CPAPER
AB - objeCtives: DVT can lead to significant co-morbidity with post-thrombotic syn- drome, and has the potential to cause life threatening pulmonary emboli. The national institute for clinical excellence (NICE) implemented stringent guidelines to improve screening for DVT and optimise management (NICE 2012). The Royal London Hospital was the designated teaching hospital receiving attending public, foreign dignitaries and athletes during the 2012 Olympics. We conducted a pro- spective audit to assess incidence of DVT in a mobile population during the 2012 Olympics, and assess adherence to NICE guidelines. Methods: Patients present- ing with symptoms of DVT over 7 weeks during the 2012 Olympics were seen by a senior nurse. A clinical proforma identifying risk factors was employed. D-dimer and USS results were obtained from clinical reporting systems. Analysis undertaken on excel. Results: 69 patients with a suspected DVT underwent investigations. Only six patients had a DVT on Doppler USS. One DVT was deemed unprovoked in a young patient with upper limb DVT. In this patient CT abdomen/pelvis was not warranted, though tested for antiphospholipid syndrome, serum calcium was not measured. In the D-dimer positive scan negative cohort, a repeat USS Doppler at 6-8 days was not undertaken in 71% of patients. However, the initial scan was undertaken within 24hrs (86%). D-dimer has low sensitivity for DVT diagnosis (14%), but high specificity (100%) albeit within limited sample size. Further, utilising risk factors (Wells score) alone had a better sensitivity (28%). ConClusions: We note a low incidence of DVT in this young mobile population, in comparison to the gen- eral population. A repeat Doppler USS 6-8days after presentation, when D-dimer was positive, is not adhered to; however none performed were positive (9). We are uncertain if this approach would add to a reduction in morbidity/mortality (BMJ 2012). The D-dimer is not a sensitive marker of DVT, and risk stratification th
AU - Emmanuel,J
AU - Wells,M
AU - Raichura,H
AU - Gunawan,A
AU - McLoughlin,T
AU - Mullish,BH
AU - Wilson,L
DO - 10.1016/j.jval.2014.03.887
EP - 152
PY - 2014///
SP - 152
TI - Low Incidence of Venous Thromboembolism in Mobile Populations
UR - http://dx.doi.org/10.1016/j.jval.2014.03.887
ER -