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‘Hospice inpatient deep vein thrombosis detection (HIDDen) in advanced non-malignant diseases’: a longitudinal pilot study

White, Clare; Noble, Simon; Swan, Flavia; Watson, Max; Allgar, Victoria; Napier, Eoin; Nelson, Annmarie; Johnson, Miriam J


Clare White

Simon Noble

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Dr Flavia Swan
Research fellow in cancer rehabilitation

Max Watson

Victoria Allgar

Eoin Napier

Annmarie Nelson


Objectives To gain preliminary data regarding the prevalence of proximal deep vein thrombosis (DVT) in those with non-malignant conditions admitted to specialist palliative care units (SPCUs).

Methods Data were collected as part of a prospective longitudinal observational study in five SPCUs in England, Wales and Northern Ireland (Registration: ISRCTN97567719) to estimate the prevalence of proximal femoral vein DVT in people admitted to SPCUs. The primary outcome for this exploratory substudy was the prevalence of DVT in patients with non-malignant palliative conditions. Consecutive consenting adults underwent bilateral femoral vein ultrasonography within 48 hours of admission. Data were collected on symptoms associated with venous thromboembolism. Patients were ineligible if the estimated prognosis was [less than] 5 days. Cross-sectional descriptive analysis was conducted on baseline data and prevalence estimates presented with 95% CIs.

Results 1390 patients were screened, 28 patients had non-malignant disease and all were recruited. The mean age 68·8 (SD 12·0), range 43–86 years; men 61%; survival mean 86 (SD 108.5) range 1–345 days. No patient had a history of venous thromboembolism. Four (14%) were receiving thromboprophylaxis. Of 22 evaluable scans, 8 (36%, 95% CI: 17% to 59%) showed femoral vein DVT. The level of reported relevant symptoms (leg oedema, leg pain, chest pain and breathlessness) was high irrespective of the presence of DVT.

Conclusions Our exploratory data indicate one in three people admitted to an SPCU with non-malignant disease had a femoral vein DVT. Although definitive conclusions cannot be drawn, these data justify a larger prospective survey.

Journal Article Type Article
Publication Date Feb 11, 2020
Journal BMJ Supportive & Palliative Care
Print ISSN 2045-435X
Electronic ISSN 2045-4368
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Pages bmjspcare-2019-002039
APA6 Citation White, C., Noble, S., Swan, F., Watson, M., Allgar, V., Napier, E., …Johnson, M. J. (2020). ‘Hospice inpatient deep vein thrombosis detection (HIDDen) in advanced non-malignant diseases’: a longitudinal pilot study. BMJ supportive & palliative care, bmjspcare-2019-002039.
Keywords Venous thromboembolism; Non-malignant; Hospices; Palliative care; Thromboprophylaxis; DVT
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Copyright Statement
©2020 The authors. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International licence.

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