The fate of the patient with deep vein thrombosis

: Late results in 278 consecutive patients with unilateral deep vein thrombosis treated with streptokinase or heparin/dicoumarol were analysed as to mortality rate, recurrent thrombo-embolism and incidence of postthrombotic syndrome (PTS). The five-year mortality rate was three times as high as that of the age-matched population. The overall mortality rate was 16%, more than half the patients dying of tumour, males largely of gastric or bronchial carcinoma, females of urogenital carcinoma. Thrombo-embolism had recurred in 14% of 204 patients who had been re-examined, in 9% thrombosis, in 3% pulmonary embolism, and in 2% both. A PTS without ulcer had developed in 16%, an ulcer in 8%. The PTS incidence correlated with the original extent of the thrombosis: no PTS if the thrombosis had been confined to the lower-leg axis, but 34% after four-level thrombosis. The data confirm the importance of thrombo-embolism prophylaxis, early diagnosis and subsequent treatment with anticoagulants and compression.