title: A clinical score to rule out the concomitant presence of deep vein thrombosis in patients presenting with superficial vein thrombosis: The ICARO study.
abstract: BACKGROUND
  Superficial vein thrombosis (SVT) is commonly encountered in clinical practice. Recent studies have suggested that the concomitant presence of deep vein thrombosis (DVT) or pulmonary embolism (PE) at the time of SVT diagnosis is not uncommon, thus increasing the interest on this disease. Whether this coexistence is predicted by specific risk factors remains unknown.
  
  
  OBJECTIVE
  To evaluate potential risk factors for DVT coexistence in patients presenting with acute objectively diagnosed SVT of the lower limbs and to develop a simple score entirely based on clinical variables to define the pre-test probability of DVT in these patients.
  
  
  METHODS
  A multicenter, retrospective cohort study on SVT patients was conducted. Information was collected on clinical signs and on risk factors for venous thrombosis.
  
  
  RESULTS
  494 patients (mean age 56.3 ± 17.9 years, 64.2% women) were included. Concomitant DVT was found in 16.0% of patients. After multivariate analysis, we identified 5 independent variables that were used to develop the ICARO score: active malignancy (1.5 points), limb edema (1.5 points), rope-like sign (-1 point), age ≥ 50 years (1 point), unprovoked SVT (-1 point). The prevalence of concomitant DVT was 1.1% in the low-probability category (< 0 points), 12.0% in the intermediate-probability category (0 to 1 points), and 32.3% in the high probability category (≥ 1.5 points).
  
  
  CONCLUSIONS
  The concomitant presence of major DVT is not negligible in patients with SVT. Our prediction score entirely based on simple clinical variables may be useful in assessing the risk of concomitant DVT in these patients.
authors.affiliation: Department of Clinical Medicine, ASO S. Croce e Carle, Cuneo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pomero
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy; Unit of cell and molecular biology in cardiovascular diseases, Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: M N D
authors.initials: MN
authors.lastname: Di Minno
authors.affiliation: Department of Clinical Medicine, Insubria University, Varese, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Tamburini Premunian
authors.affiliation: Haematology Unit, University of Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Malato
authors.affiliation: Center for Hemorrhagic and Thrombotic Diseases, University Hospital of Udine, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pasca
authors.affiliation: Center for Hemorrhagic and Thrombotic Diseases, University Hospital of Udine, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barillari
authors.affiliation: Department of Clinical Medicine, ASO S. Croce e Carle, Cuneo, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fenoglio
authors.affiliation: Haematology Unit, University of Palermo, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Siragusa
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Minno
authors.affiliation: Department of Clinical Medicine, Insubria University, Varese, Italy.
authors.forename: W
authors.initials: W
authors.lastname: Ageno
authors.affiliation: Department of Clinical Medicine, Insubria University, Varese, Italy. Electronic address: fdentali@libero.it.
authors.forename: F
authors.initials: F
authors.lastname: Dentali
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology* / Q000473:pathology
keywords: Pulmonary embolism; Risk factors; Saphenous vein; Ultrasonography; Venous thrombosis