Evidence-based On-call

Deep vein thrombosis

Prognosis

Silent pulmonary embolism is common ^b though few patients develop serious problems if anticoagulated.

Patients are at increased risk of

recurrent venous thromboembolism (a quarter within 5 years) ^a
post-thrombotic leg (a quarter within 5 years) ^a
- symptoms: pain, cramps, heaviness, pruritis, paraesthesia
- signs: pretibial oedema, skin induration, hyperpigmentation, redness, pain on calf compression
dying (a quarter within 5 years) ^a

The risk of recurrent venous thromboembolism is increased with

and reduced with

The risk of dying is increased with cancer.

^a
Patients are slightly more likely to have cancer diagnosed in the next year.

The risk of post-thrombotic leg is increased with ipsilateral recurrent DVT. ^a

Upper limb DVT

Death is common. PE and chronic arm swelling are rarer. ^c