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Multicenter Study
. 2019 Jan;47(1):96-101.
doi: 10.1007/s11239-018-1754-7.

Ruling out deep vein thrombosis in patients with superficial vein thrombosis: external validation of the ICARO score

Paul Frappé  1   2   3   4   5 , Quentin Brosse  6 , Benjamin Seffert  7 , Hervé Décousus  8   9   7 , Laurent Bertoletti  8   9   7 ; STEPH Study Group
Affiliations
Multicenter Study

Ruling out deep vein thrombosis in patients with superficial vein thrombosis: external validation of the ICARO score

Paul Frappé et al. J Thromb Thrombolysis. 2019 Jan.

Abstract

A clinical score was recently proposed to rule out concomitant DVT in patients with a clinical suspicion of SVT. This study aimed to assess the external validity of this score in patients from the STEPH study. We performed a post-hoc analysis of data from the STEPH study. The STEPH study was a prospective multicenter community-based study conducted during a 1-year period in the resident adult population of the Greater Saint-Etienne urban area (France). Every patient with a clinical suspicion of SVT underwent a venous compression ultrasonography, to confirm SVT and to assess the presence of a concomitant DVT or not. Odds ratios for concomitant DVT were calculated for each item of the ICARO score. We then computed the score for each patient, and performed a receiver operating characteristic (ROC) curve analysis. In univariate analysis, none of the ICARO items were significantly different given the presence of a concomitant DVT. Given computed scores, 55 patients (45.1%) had a low risk, 17 (13.9%) had an intermediate risk and 50 (41.0%) had a high risk of a concomitant DVT. The area under the ROC curve was 0.386 [95% CI, 0.268-0.504]. When risk levels were dichotomized as low vs intermediate-high risk, the ICARO score had a sensitivity of 36.0%, a specificity of 40.2%, a positive predictive value of 13.4% and a negative predictive value of 70.9%. Our study does not confirm the utility of the ICARO clinical score to rule out concomitant DVT in case of SVT.

Keywords: Pulmonary embolism; Risk factors; Saphenous vein; Ultrasonography; Venous thrombosis.

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