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Ultrasonographic Screening for Deep Venous Thrombosis after Arthroplasty
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
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TO THE EDITOR:
It is interesting that Robinson and colleagues' study [1] shows a rate of deep vein thrombosis after hospital discharge (2.5%) that is lower than the rates reported by Planes [2] and Bergqvist [3] and their colleagues. The main reason for the lower incidence in Robinson and coworkers' study is the inclusion of only proximal deep venous thrombosis as diagnosed by ultrasonography. In contrast, the other two studies included both proximal and distal deep venous thrombosis diagnosed by venography. The incidence of proximal deep venous thrombosis is similar in all three studies, but undiagnosed distal deep venous thrombosis (which is asymptomatic) occurred in approximately 10% of patients in the other two studies. Distal deep venous thrombosis is clinically important because it can increase risk for proximal deep venous thrombosis and the postphlebitic syndrome. Robinson and colleagues did not consider these conditions. We agree that there is no need for screening at hospital discharge, but we believe it is important to continue prophylaxis with low-molecular-weight heparin or coumarin for up to 6 to 8 weeks. This regimen has been shown to be safe and effective in reducing risk for both proximal and distal deep venous thrombosis.
Vijay Rajput, MD
Vipul Nanavati, BSME
Robert Wood Johnson Medical School; Camden, NJ 08103
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
