Introduction and objective:

deep venous thrombosis (DVT) is a significant economic burden. The study primary endpoint is to compare two diagnostic strategies in terms of cost and effectiveness: D-dimer to all patients with suspected DVT vs conditioning it to the pre-test clinical probability; the secondary endpoint is to analyze the cost of DVT diagnosis in our center and the factors associated with its presentation.

Material and methods:

this was a prospective study of patients with suspected DVT of lower extremities conducted between May and October 2019. The variables of the Wells scale, associated PTE, D-dimer levels, Doppler echocardiography and costs (emergency care, D-dimer and Doppler echocardiography obtained from the region Official Bulletin and the hospital billing unit) were analyzed. The statistical analysis was performed with SPSS, the chi-square test, and Fisher's exact test.

Results:

a total of 249 patients were studied, 116 of whom (46.59 %) presented with DVT. The mean age was 70 years (21-). Those with DVT were predominantly men (52.6 % vs 39.8 %; p = .04), had cancer (29.3 % vs 16.5 %, p = 0.016), pain (80.2 % vs 45.1 %; p < .001), edema (93.1 % vs 57.1 %, p < .001), slurring (72.4 % vs 14.3 %; p < .001), PTE (25.9 % vs 13.5 %, p = .014), less alternative diagnosis (0.9 % vs 62.4 %; p = .001) and less obesity (7.8 % vs 18.8 %; p = .011). The cost generated was € 192.49 per patient. Regarding the primary endpoint, 144 patients (those with D-dimer) were analyzed. Strategy #1 resulted in a cost of €190.41 per patient with 100 % sensitivity and 7.1 % specificity; strategy # 2, resulted in a cost of €188.51/patient, with 88.3 % and 78.5 % sensitivity and specificity rates, respectively. Both strategies are 1 % and 2 % cheaper than the cost generated.

Conclusion:

the application of diagnostic algorithms for suspected DVT is cost-effective, so its use should be generalized.

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