Doppler color flow imaging surveillance of deep vein thrombosis in high-risk trauma patients.

To determine the prevalence of upper and lower extremity deep vein thrombosis in high-risk trauma patients, 136 consecutive high-risk trauma patients were prospectively evaluated with weekly Doppler color flow imaging. Incomplete compressibility and visualized intraluminal thrombus were considered diagnostic of deep vein thrombosis. Pulmonary embolus was documented by pulmonary arteriography. Deep vein thrombosis occurred at 27 non-contiguous sites in 19 patients (14%). Eight of 27 cases of deep vein thrombosis (30%) involved the upper extremity and 19 (70%) occurred in the lower extremity. Twenty-one of 27 deep vein thromboses (78%) were partially occlusive, whereas six (22%) were occlusive. Pulmonary embolus was documented in three patients (2.2%). Doppler color flow imaging detected occult deep vein thrombosis in 14% of high-risk trauma patients (30% occurring in the upper extremity).