{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:11:12Z","timestamp":1780351872842,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["Ricerca Corrente  09C834_2018"],"award-info":[{"award-number":["Ricerca Corrente  09C834_2018"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Intern Emerg Med"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The diagnosis of venous thromboembolism (VTE) is complex, and many cases of pulmonary embolism (PE) and deep vein thrombosis (DVT) go undetected despite validated diagnostic algorithms. This study evaluated the diagnostic performance of compression ultrasound (CUS) when systematically performed in patients admitted to an internal medicine department for dyspnea and\/or respiratory failure. We conducted a prospective observational cohort study of consecutive adult hospitalized patients admitted for dyspnea and\/or respiratory failure with at least one of the following: tachycardia (&gt;\u2009100\u00a0bpm), tachypnea (&gt;\u200920\/min), chest pain, cough, syncope, or hemoptysis. Patients with a previous diagnosis of VTE or who underwent computed tomography pulmonary angiography (CTPA) or CUS during evaluation in the emergency department were excluded. The study included 263 patients (50.2% women, average age 84\u00a0years). CUS was positive in 31 patients (11.8%); Bilateral DVT was diagnosed in two patients and unilateral DVT in 29 patients. Of these, 10 underwent CT scan, with PE confirmed in 9 cases. Using the Wells score for DVT (cut-off\u2009\u2265\u20092), only 8 patients (25.8%) were at high risk. The accuracy of the Wells score in identifying PE was suboptimal, as 5 of 9 patients (55.5%) with confirmed PE were in the low-risk group (three-level interpretation) and 8 (89.9%) were in the \u201cEP unlikely\u201d group (two-level interpretation). The systematic use of CUS as a point-of-care tool can improve the diagnostic accuracy for VTE in patients admitted to internal medicine departments with dyspnea\/respiratory failure.<\/jats:p>","DOI":"10.1007\/s11739-024-03773-7","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T15:03:20Z","timestamp":1730905400000},"page":"181-187","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic value of systematic compression ultrasonography for the detection of unrecognized venous thromboembolism in patients admitted to an internal medicine ward for dyspnea"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7863-8192","authenticated-orcid":false,"given":"Daniele","family":"Sola","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Bonometti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Comola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia Francesca","family":"Manfredi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Perazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Patrucco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Gavelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Scacchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Prina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Pirisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Bellan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"3773_CR1","doi-asserted-by":"publisher","first-page":"3060","DOI":"10.1016\/S0140-6736(16)30514-1","volume":"388","author":"M Di Nisio","year":"2016","unstructured":"Di Nisio M, van Es N, B\u00fcller HR (2016) Deep vein thrombosis and pulmonary embolism. Lancet (London, England) 388:3060\u20133073","journal-title":"Lancet (London, England)"},{"key":"3773_CR2","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/S0140-6736(20)32658-1","volume":"398","author":"F Khan","year":"2021","unstructured":"Khan F, Tritschler T, Kahn SR, Rodger MA (2021) Venous thromboembolism. Lancet (London, England) 398:64\u201377","journal-title":"Lancet (London, England)"},{"key":"3773_CR3","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.thromres.2021.08.015","volume":"206","author":"N Wenger","year":"2021","unstructured":"Wenger N, Sebastian T, Engelberger RP, Kucher N, Spirk D (2021) Pulmonary embolism and deep vein thrombosis: similar but different. Thromb Res 206:88\u201398","journal-title":"Thromb Res"},{"key":"3773_CR4","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1001\/jamainternmed.2023.8232","volume":"184","author":"B Teja","year":"2024","unstructured":"Teja B et al (2024) Complication rates of central venous catheters: a systematic review and meta-analysis. JAMA Intern Med 184:474\u2013482","journal-title":"JAMA Intern Med"},{"key":"3773_CR5","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1055\/s-0042-1757937","volume":"39","author":"Y Koethe","year":"2022","unstructured":"Koethe Y, Bochnakova T, Kaufman CS (2022) Upper extremity deep venous thrombosis: etiologies, diagnosis, and updates in therapeutic strategies. Semin Intervent Radiol 39:475\u2013482","journal-title":"Semin Intervent Radiol"},{"key":"3773_CR6","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1161\/CIRCRESAHA.115.306841","volume":"118","author":"AM Wendelboe","year":"2016","unstructured":"Wendelboe AM, Raskob GE (2016) Global burden of thrombosis: epidemiologic aspects. Circ Res 118:1340\u20131347","journal-title":"Circ Res"},{"key":"3773_CR7","doi-asserted-by":"publisher","first-page":"2363","DOI":"10.1161\/ATVBAHA.114.304488","volume":"34","author":"GE Raskob","year":"2014","unstructured":"Raskob GE et al (2014) Thrombosis: a major contributor to global disease burden. Arterioscler Thromb Vasc Biol 34:2363\u20132371","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"3773_CR8","first-page":"107602961882328","volume":"25","author":"A Amin","year":"2019","unstructured":"Amin A, Neuman WR, Lingohr-Smith M, Menges B, Lin J (2019) Venous thromboembolism prophylaxis and risk for acutely medically ill patients stratified by different ages and renal disease status. Clin Appl Thromb Off J Int Acad Clin Appl Thromb 25:1076029618823287","journal-title":"Clin Appl Thromb Off J Int Acad Clin Appl Thromb"},{"key":"3773_CR9","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1160\/TH07-03-0212","volume":"98","author":"AT Cohen","year":"2007","unstructured":"Cohen AT et al (2007) Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 98:756\u2013764","journal-title":"Thromb Haemost"},{"key":"3773_CR10","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1097\/CNQ.0000000000000159","volume":"40","author":"S Alhassan","year":"2017","unstructured":"Alhassan S et al (2017) Clinical presentation and risk factors of venous thromboembolic disease. Crit Care Nurs Q 40:201\u2013209","journal-title":"Crit Care Nurs Q"},{"key":"3773_CR11","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2022.37.e76","volume":"37","author":"J An","year":"2022","unstructured":"An J et al (2022) Acute pulmonary embolism and chronic thromboembolic pulmonary hypertension: clinical and serial CT pulmonary angiographic features. J Korean Med Sci 37:e76","journal-title":"J Korean Med Sci"},{"key":"3773_CR12","first-page":"107602962211310","volume":"28","author":"Y Shi","year":"2022","unstructured":"Shi Y et al (2022) Silent pulmonary embolism in deep vein thrombosis: relationship and risk factors. Clin Appl Thromb Off J Int Acad Clin Appl Thromb 28:10760296221131034","journal-title":"Clin Appl Thromb Off J Int Acad Clin Appl Thromb"},{"key":"3773_CR13","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","volume":"41","author":"SV Konstantinides","year":"2020","unstructured":"Konstantinides SV et al (2020) 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 41:543\u2013603","journal-title":"Eur Heart J"},{"key":"3773_CR14","doi-asserted-by":"publisher","first-page":"997","DOI":"10.7326\/0003-4819-129-12-199812150-00002","volume":"129","author":"PS Wells","year":"1998","unstructured":"Wells PS et al (1998) Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 129:997\u20131005","journal-title":"Ann Intern Med"},{"key":"3773_CR15","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1001\/jama.279.14.1094","volume":"279","author":"SS Anand","year":"1998","unstructured":"Anand SS et al (1998) Does this patient have deep vein thrombosis? JAMA 279:1094\u20131099","journal-title":"JAMA"},{"key":"3773_CR16","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.thromres.2020.07.026","volume":"196","author":"J Coelho","year":"2020","unstructured":"Coelho J et al (2020) Comparison of the Wells score and the revised Geneva score as a tool to predict pulmonary embolism in outpatients over age 65. Thromb Res 196:120\u2013126","journal-title":"Thromb Res"},{"key":"3773_CR17","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1007\/s11239-015-1250-2","volume":"41","author":"J-H Shen","year":"2016","unstructured":"Shen J-H et al (2016) Comparison of the Wells score with the revised Geneva score for assessing suspected pulmonary embolism: a systematic review and meta-analysis. J Thromb Thrombolysis 41:482\u2013492","journal-title":"J Thromb Thrombolysis"},{"key":"3773_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.pulmoe.2023.10.002","author":"Y Zhao","year":"2023","unstructured":"Zhao Y et al (2023) The Legend score synthesizes Wells, PERC, Geneva, D-dimer and predicts acute pulmonary embolism prior to imaging tests. Pulmonology. https:\/\/doi.org\/10.1016\/j.pulmoe.2023.10.002","journal-title":"Pulmonology"},{"key":"3773_CR19","doi-asserted-by":"publisher","first-page":"165","DOI":"10.7326\/0003-4819-144-3-200602070-00004","volume":"144","author":"G Le Gal","year":"2006","unstructured":"Le Gal G et al (2006) Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 144:165\u2013171","journal-title":"Ann Intern Med"},{"key":"3773_CR20","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.thromres.2017.06.002","volume":"163","author":"JA Kline","year":"2018","unstructured":"Kline JA (2018) Diagnosis and exclusion of pulmonary embolism. Thromb Res 163:207\u2013220","journal-title":"Thromb Res"},{"key":"3773_CR21","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1001\/jama.2017.21904","volume":"319","author":"Y Freund","year":"2018","unstructured":"Freund Y et al (2018) Effect of the pulmonary embolism rule-out criteria on subsequent thromboembolic events among low-risk emergency department patients: the PROPER randomized clinical trial. JAMA 319:559\u2013566","journal-title":"JAMA"},{"key":"3773_CR22","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.annemergmed.2010.07.010","volume":"56","author":"JG Crisp","year":"2010","unstructured":"Crisp JG, Lovato LM, Jang TB (2010) Compression ultrasonography of the lower extremity with portable vascular ultrasonography can accurately detect deep venous thrombosis in the emergency department. Ann Emerg Med 56:601\u2013610","journal-title":"Ann Emerg Med"},{"key":"3773_CR23","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1160\/TH06-03-0158","volume":"95","author":"G Le Gal","year":"2006","unstructured":"Le Gal G et al (2006) A positive compression ultrasonography of the lower limb veins is highly predictive of pulmonary embolism on computed tomography in suspected patients. Thromb Haemost 95:963\u2013966","journal-title":"Thromb Haemost"},{"key":"3773_CR24","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1097\/MEJ.0000000000000683","volume":"27","author":"HA Valle","year":"2020","unstructured":"Valle HA et al (2020) Nonsuspected pulmonary embolism in the emergency department. Eur J Emerg Med Off J Eur Soc Emerg Med 27:379\u2013380","journal-title":"Eur J Emerg Med Off J Eur Soc Emerg Med"},{"key":"3773_CR25","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1111\/j.1532-5415.2005.53309.x","volume":"53","author":"M Righini","year":"2005","unstructured":"Righini M, Le Gal G, Perrier A, Bounameaux H (2005) The challenge of diagnosing pulmonary embolism in elderly patients: influence of age on commonly used diagnostic tests and strategies. J Am Geriatr Soc 53:1039\u20131045","journal-title":"J Am Geriatr Soc"},{"key":"3773_CR26","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12959-022-00433-8","volume":"20","author":"L Loffredo","year":"2022","unstructured":"Loffredo L et al (2022) Asymptomatic and symptomatic deep venous thrombosis in hospitalized acutely ill medical patients: risk factors and therapeutic implications. Thromb J 20:72","journal-title":"Thromb J"},{"key":"3773_CR27","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1378\/chest.08-1516","volume":"135","author":"J Rizkallah","year":"2009","unstructured":"Rizkallah J, Man SFP, Sin DD (2009) Prevalence of pulmonary embolism in acute exacerbations of COPD: a systematic review and metaanalysis. Chest 135:786\u2013793","journal-title":"Chest"},{"key":"3773_CR28","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1002\/ags3.12709","volume":"7","author":"K Hagiwara","year":"2023","unstructured":"Hagiwara K, Watanabe Y, Suzuki T, Okamura Y, Yamashita H (2023) Prevalence of preoperative asymptomatic deep vein thrombosis in patients undergoing elective general surgery for benign disease. Ann Gastroenterol Surg 7:1042\u20131048","journal-title":"Ann Gastroenterol Surg"},{"key":"3773_CR29","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1016\/S0741-5214(97)70088-0","volume":"26","author":"LM Harris","year":"1997","unstructured":"Harris LM et al (1997) Screening for asymptomatic deep vein thrombosis in surgical intensive care patients. J Vasc Surg 26:764\u2013769","journal-title":"J Vasc Surg"},{"key":"3773_CR30","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1111\/jth.12522","volume":"12","author":"N Mumoli","year":"2014","unstructured":"Mumoli N et al (2014) Accuracy of nurse-performed compression ultrasonography in the diagnosis of proximal symptomatic deep vein thrombosis: a prospective cohort study. J Thromb Haemost 12:430\u2013435","journal-title":"J Thromb Haemost"},{"key":"3773_CR31","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1111\/jth.13407","volume":"14","author":"JD Costa Rodrigues","year":"2016","unstructured":"Costa Rodrigues JD, Alzuphar S, Combescure C, Le Gal G, Perrier A (2016) Diagnostic characteristics of lower limb venous compression ultrasonography in suspected pulmonary embolism: a meta-analysis. J Thromb Haemost 14:1765\u20131772","journal-title":"J Thromb Haemost"}],"container-title":["Internal and Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11739-024-03773-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11739-024-03773-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11739-024-03773-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T17:37:45Z","timestamp":1738690665000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11739-024-03773-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,6]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["3773"],"URL":"https:\/\/doi.org\/10.1007\/s11739-024-03773-7","relation":{},"ISSN":["1828-0447","1970-9366"],"issn-type":[{"value":"1828-0447","type":"print"},{"value":"1970-9366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,6]]},"assertion":[{"value":"16 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors declare the absence of conflicts of interest, the patients included in the study signed an informed consent after having been informed about the nature and purposes of the study. The study was conducted in strict accordance with the Declaration of Helsinki and approved by the local Institutional Review Board (IRB number: CE 189\/19).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest, Human and animal rights statement and Informed consent"}}]}}