{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T23:34:27Z","timestamp":1776987267876,"version":"3.51.4"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"name":"Lorenzo Loffredo","award":["Universit\u00e0 degli Studi di ROMA \u201cla Sapienza\u201d"],"award-info":[{"award-number":["Universit\u00e0 degli Studi di ROMA \u201cla Sapienza\u201d"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Distal deep venous thrombosis (DDVT) is a clinical condition that can affect patients hospitalized in internal medicine wards and may result in pulmonary embolism. However, many aspects of distal thrombosis in hospitalized medical patients remain poorly understood.<\/jats:p>\n                  <jats:p>This study aimed to evaluate the rate of asymptomatic DDVT at admission, the occurrence of DDVT during hospitalization, and to analyze the factors associated with thrombotic events.<\/jats:p>\n                  <jats:p>A multicenter, prospective observational study (AURELIO) was conducted across eight centers affiliated with the Ultrasound Study Group of the Italian Society of Internal Medicine. Venous ultrasound of the lower limb veins was performed within 48\u2009hours of admission and at discharge to diagnose distal deep vein thrombosis.<\/jats:p>\n                  <jats:p>Among 1,458 patients (721 males and 737 females; mean age 71\u2009\u00b1\u200916 years), asymptomatic distal thrombosis was detected in 59 patients (4%) upon admission. Of these, 47% (n\u2009=\u200928) were classified as isolated DDVT, while 31 cases involved DDVT that extended to the proximal tract. At discharge, 9 additional cases of distal thrombosis were identified, bringing the total to 68 cases. Of these, 46% were DDVT, while 54% DDVT extended to the proximal venous system. Multivariate analysis identified reduced mobility (p\u2009=\u20090.036) and active malignancy (p\u2009=\u20090.02) as independent risk factors for DDVT extending to the proximal tract. Additionally, pneumonia (p\u2009=\u20090.043) and active malignancy (p\u2009=\u20090.008) were associated with DDVT.<\/jats:p>\n                  <jats:p>The study emphasizes the high prevalence of DDVT in hospitalized patients and the risk of proximal extension. Ultrasound screening should be considered for oncology patients and those with pneumonia to ensure early diagnosis and timely anticoagulant therapy.<\/jats:p>","DOI":"10.1055\/a-2595-5458","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T18:48:16Z","timestamp":1745866096000},"page":"488-495","source":"Crossref","is-referenced-by-count":0,"title":["Predictors, Incidence, and Proximal Extension Rate of Distal Deep Vein Thrombosis in Internal Medicine Wards: Insights from the AURELIO Study"],"prefix":"10.1055","volume":"126","clinical-trial-number":[{"clinical-trial-number":"nct03157843","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-6235","authenticated-orcid":false,"given":"Lorenzo","family":"Loffredo","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Maggio","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Magna","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianpaolo","family":"Vidili","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Sciacqua","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna-Gr\u00e6cia of Catanzaro, Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Cogliati","sequence":"additional","affiliation":[{"name":"Department of Internal medicine, L. Sacco Hospital, ASST-fbf-Sacco, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sciaila","family":"Bernardini","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Fallarino","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria Maria","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Pannunzio","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Bagnato","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nausica","family":"Polisena","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Serra","sequence":"additional","affiliation":[{"name":"Interventional, Diagnostic and Therapeutic Ultrasound Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Falsetti","sequence":"additional","affiliation":[{"name":"Clinica Medica, Dipartimento di Scienze Cliniche e Molecolari, Universit\u00e0 Politecnica delle Marche, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Zaccone","sequence":"additional","affiliation":[{"name":"Internal and Subintensive Medicine, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evaristo","family":"Ettorre","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovambattista","family":"Desideri","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Santoro","sequence":"additional","affiliation":[{"name":"Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vito","family":"Cantisani","sequence":"additional","affiliation":[{"name":"Department of Radiology, Oncology and Pathology, Sapienza University of Rome, Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasquale","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Santoliquido","sequence":"additional","affiliation":[{"name":"Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-7068","authenticated-orcid":false,"given":"Francesco","family":"Violi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sapienza University of Rome, Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"AURELIO Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"issue":"S 01","key":"ref1","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1016\/j.thromres.2018.01.028","article-title":"Morbidity, mortality and costs associated with venous thromboembolism in hospitalized patients with cancer","volume":"164","author":"G H Lyman","year":"2018","journal-title":"Thromb Res"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.mayocp.2018.07.020","article-title":"Low rate of intrahospital deep venous thrombosis in acutely ill medical patients: results from the AURELIO study","volume":"94","author":"L Loffredo","year":"2019","journal-title":"Mayo Clin Proc"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1538-7836.2011.04564.x","article-title":"Isolated distal deep vein thrombosis: what we know and what we are doing","volume":"10","author":"G Palareti","year":"2012","journal-title":"J Thromb Haemost"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1001\/jamacardio.2022.1988","article-title":"Clinical presentation and short- and long-term outcomes in patients with isolated distal deep vein thrombosis vs proximal deep vein thrombosis in the RIETE registry","volume":"7","author":"B Bikdeli","year":"2022","journal-title":"JAMA Cardiol"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1055\/s-0039-1693461","article-title":"Isolated distal deep vein thrombosis: perspectives from the GARFIELD-VTE registry","volume":"119","author":"S M Schellong","year":"2019","journal-title":"Thromb Haemost"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/MOH.0000000000000670","article-title":"Significance and management of isolated distal deep vein thrombosis","volume":"28","author":"I Makedonov","year":"2021","journal-title":"Curr Opin Hematol"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1002\/bjs.10152","article-title":"Systematic review of the complications following isolated calf deep vein thrombosis","volume":"103","author":"J Garry","year":"2016","journal-title":"Br J Surg"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1024\/0301-1526\/a000869","article-title":"Calf deep vein thrombosis\u2014clinical relevance, diagnostic approaches and therapeutic options","volume":"49","author":"G Elmi","year":"2020","journal-title":"Vasa"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"487","DOI":"10.3400\/avd.oa.19-00128","article-title":"Clinical course of asymptomatic isolated distal deep vein thrombosis of the leg: a single-institution study","volume":"12","author":"N Shimabukuro","year":"2019","journal-title":"Ann Vasc Dis"},{"issue":"04","key":"ref10","first-page":"CD013422","article-title":"Treatment of distal deep vein thrombosis","volume":"4","author":"G Kirkilesis","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1111\/jth.13677","article-title":"Anticoagulation in patients with isolated distal deep vein thrombosis: a meta-analysis","volume":"15","author":"L Franco","year":"2017","journal-title":"J Thromb Haemost"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.thromres.2012.05.018","article-title":"Incidence and characteristics of asymptomatic distal deep vein thrombosis unexpectedly found at admission in an internal medicine setting","volume":"130","author":"G Ciuti","year":"2012","journal-title":"Thromb Res"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"109148","DOI":"10.1016\/j.thromres.2024.109148","article-title":"Rate and predictors of thromboprophylaxis in internal medicine wards: results from the AURELIO study","volume":"243","author":"A Magna","year":"2024","journal-title":"Thromb Res"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s12959-023-00550-y","article-title":"The clinical application of venous ultrasound in diagnosis and follow-up of lower extremity deep vein thrombosis (DVT): a case-based discussion","volume":"21","author":"F Akram","year":"2023","journal-title":"Thromb J"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"I22","DOI":"10.1161\/01.CIR.0000078464.82671.78","article-title":"Natural history of venous thromboembolism","volume":"107","author":"C Kearon","year":"2003","journal-title":"Circulation"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12959-022-00433-8","article-title":"Asymptomatic and symptomatic deep venous thrombosis in hospitalized acutely ill medical patients: risk factors and therapeutic implications","volume":"20","author":"L Loffredo","year":"2022","journal-title":"Thromb J"},{"issue":"05","key":"ref17","first-page":"1063","article-title":"Evolution of untreated calf deep-vein thrombosis in high risk symptomatic outpatients: the blind, prospective CALTHRO study","volume":"104","author":"G Palareti","year":"2010","journal-title":"Thromb Haemost"},{"issue":"10","key":"ref18","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1253\/circj.CJ-20-0270","article-title":"Risk factors for progression of distal deep vein thrombosis","volume":"84","author":"S Fujioka","year":"2020","journal-title":"Circ J"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"e239","DOI":"10.1055\/s-0041-1730038","article-title":"Management and outcomes of isolated distal deep vein thromboses: a questionable trend toward long-lasting anticoagulation treatment. Results from the START-Register","volume":"5","author":"G Palareti","year":"2021","journal-title":"TH Open"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.1055\/s-0039-1683374","article-title":"Recurrence risk after first symptomatic distal versus proximal deep vein thrombosis according to baseline risk factors","volume":"3","author":"L Valerio","year":"2019","journal-title":"TH Open"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1160\/th15-06-0503","article-title":"Probability of developing proximal deep-vein thrombosis and\/or pulmonary embolism after distal deep-vein thrombosis","volume":"115","author":"A Brateanu","year":"2016","journal-title":"Thromb Haemost"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12959-022-00410-1","article-title":"Hospitalized patients with isolated distal deep vein thrombosis: anticoagulation therapy or not?","volume":"20","author":"X Luo","year":"2022","journal-title":"Thromb J"},{"issue":"07","key":"ref23","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1111\/jth.13713","article-title":"Survival and recurrent venous thromboembolism in patients with first proximal or isolated distal deep vein thrombosis and no pulmonary embolism","volume":"15","author":"S Barco","year":"2017","journal-title":"J Thromb Haemost"},{"issue":"12","key":"ref24","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1055\/s-0039-1697661","article-title":"Prophylaxis of venous thromboembolism after hospital discharge in internal medicine: findings from the observational FADOI-NoTEVole study","volume":"119","author":"A Squizzato","year":"2019","journal-title":"Thromb Haemost"},{"issue":"03","key":"ref25","first-page":"493","article-title":"Comparative study on risk factors and early outcome of symptomatic distal versus proximal deep vein thrombosis: results from the OPTIMEV study","volume":"102","author":"J P Galanaud","year":"2009","journal-title":"Thromb Haemost"},{"issue":"151","key":"ref26","doi-asserted-by":"crossref","first-page":"180119","DOI":"10.1183\/16000617.0119-2018","article-title":"Cancer-associated thrombosis: the when, how and why","volume":"28","author":"C J Fernandes","year":"2019","journal-title":"Eur Respir Rev"},{"issue":"10","key":"ref27","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3390\/cancers10100380","article-title":"Cancer-associated thrombosis: an overview of mechanisms, risk factors, and treatment","volume":"10","author":"N B Abdol Razak","year":"2018","journal-title":"Cancers (Basel)"},{"issue":"09","key":"ref28","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1111\/jth.13761","article-title":"Clinical course of isolated distal deep vein thrombosis in patients with active cancer: a multicenter cohort study","volume":"15","author":"F Dentali","year":"2017","journal-title":"J Thromb Haemost"},{"issue":"06","key":"ref29","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1055\/s-0040-1710317","article-title":"Hypercoagulation and antithrombotic treatment in coronavirus 2019: a new challenge","volume":"120","author":"F Violi","year":"2020","journal-title":"Thromb Haemost"},{"issue":"09","key":"ref30","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1055\/a-1788-7592","article-title":"The ADA (Age-D-Dimer-Albumin) score to predict thrombosis in SARS-CoV-2","volume":"122","author":"F Violi","year":"2022","journal-title":"Thromb Haemost"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.jvsv.2020.08.028","article-title":"Deep vein thrombosis in noncritically ill patients with coronavirus disease 2019 pneumonia: deep vein thrombosis in nonintensive care unit patients","volume":"9","author":"X Jimenez-Guiu","year":"2021","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.thromres.2024.01.023","article-title":"Incidence and risk factors of post-thrombotic syndrome in patients with isolated calf vein thrombosis. Findings from the GARFIELD-VTE registry","volume":"235","author":"P Prandoni","year":"2024","journal-title":"Thromb Res"},{"issue":"05","key":"ref33","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1177\/1358863X21996825","article-title":"Relevance of immobility as a risk factor for symptomatic proximal and isolated distal deep vein thrombosis in acutely ill medical inpatients","volume":"26","author":"M Sartori","year":"2021","journal-title":"Vasc Med"},{"issue":"05","key":"ref34","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.annonc.2022.12.014","article-title":"Venous thromboembolism in cancer patients: ESMO clinical practice guideline","volume":"34","author":"A Falanga","year":"2023","journal-title":"Ann Oncol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1373635","DOI":"10.3389\/fphar.2024.1373635","article-title":"Efficacy and safety of direct oral anticoagulants for preventing venous thromboembolism in hospitalized cancer patients: a national multicenter retrospective cohort study","volume":"15","author":"S Wu","year":"2024","journal-title":"Front Pharmacol"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2595-5458.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T22:36:49Z","timestamp":1776983809000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2595-5458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":35,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2026,4,23]]},"published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2595-5458","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4,28]]},"published":{"date-parts":[[2025,4,28]]}}}