How can we improve the diagnosis of deep vein thrombosis and pulmonary embolism at the primary level?

Abstract

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is not uncommon in primary care, with a reported incidence of almost one case per 1000 person-years [1]. VTE is highly feared for its associated mortality, since the risk of PE-related early mortality may be higher than 15%, as well as its associated morbidity, since patients with VTE may also develop long-term complications such as chronic thromboembolic pulmonary hypertension or postphlebitic syndrome [2]. On the other hand, anticoagulation is an effective treatment for VTE, but carries a non-negligible rate of major bleeding events, ranging from 2% in clinical trials to 7.4% in population cohort studies [3].