Calf measurements screening for deep vein thrombosis in acute inpatient cancer rehabilitation

Abstract

Background/Aims: Cancer patients have a fourfold increase in the frequency of thrombosis and it is a common cause of death. The purpose of this study was to review the impact of calf measurements during initial admission to an inpatient rehabilitation unit to detect deep vein thrombosis. Methods: During inpatient admission to a rehabilitation unit, calf measurement assessments were performed by nursing staff. The nurses were instructed to notify clinicians for an order for a venous Doppler ultrasound if the difference between the two calves was greater than 3 cm. Findings: A total of 374 patients were admitted to the inpatient cancer rehabilitation unit over 12 months. Only six patients (2%) did not have their calves measured, with a 98% compliance of measurement. Only two patients (0.5%) had a difference in calf measurement and clinical exam significant to warrant a venous Doppler ultrasound. Both cases were negative for thrombosis. Venous Doppler ultrasounds were performed in 63 (17%) patients before admission to the rehabilitation unit. During the rehabilitation stay, venous Doppler ultrasounds were performed on 44 (12%) patients, with 10 (3%) patients identified with having deep vein thrombosis. Conclusions: This study suggests that calf measurements at admission to a rehabilitation unit were unable to detect deep vein thrombosis in this cancer population. Venous Doppler ultrasounds were ordered and identified additional patients who had deep vein thrombosis.