Assessment of the Probability of Post-thrombotic Syndrome in Patients with Lower Extremity Deep Venous Thrombosis

Abstract

This study was performed to assess the probability of post-thrombotic syndrome (PTS) after treatment of lower extremity deep venous thrombosis (LEDVT). Patients with LEDVT undergoing their first treatments in Nanjing First Hospital from January 2013 to December 2014 were enrolled in this study (156 patients were enrolled in the training cohort, and 135 patients were enrolled in the validation cohort). 51 and 45 patients developed PTS in the two cohorts, respectively. Independent risk factors for PTS were investigated in the training cohort, and these independent risk factors were employed to develop the APTSD scoring system with which to predict the probability of PTS. Four independent risk factors for PTS were identified: iliac vein compression syndrome, residual iliac-femoral vein thrombosis, residual femoral-popliteal vein thrombosis and insufficient anticoagulation. Patients in the training cohort were divided into 2 groups according to the APTSD score of ≤7.0 and >7.0 points regarding the probability of PTS (median PTS-free time, 21.82 vs. 18.84 months; P < 0.001). The accuracy of this score system was 81.7% for the training cohort and 82.5% for the validation cohort. Patients with an APTSD score of >7.0 points may have an increased probability of developing PTS.

Figure 1

Patient selection flow chart. *Patients who developed new symptoms between the follow-up periods and could not determine the time point at which the symptoms had occurred were excluded from this study.

Figure 2

(A,B) (A) No PTS probability of both APTSD score groups (0 to 7.0 points and >7.0 points) in training cohort. (B) No PTS probability of both APTSD score groups (0 to 7.0 points and >7.0 points) in validation cohort. All analyses were performed using the Kaplan-Meier method and Log-rank test.