Presenting D-dimer and early symptom severity are independent predictors for post-thrombotic syndrome following a first deep vein thrombosis

Post-thrombotic syndrome (PTS) is the most common complication of deep vein thrombosis (DVT). Current preventative strategies are limited to the daily wear of graduated compression stockings (GCS). The aim of this study was to evaluate early predictors of PTS. One hundred and twenty-two consecutive patients with a first DVT were prospectively recruited from diagnosis and followed for up to 6months post-end of anticoagulation. D-dimer was measured in 107 participants at presentation and Villalta scale was evaluated in 70 participants at a median of 2weeks following diagnosis. PTS developed in 51 center dot 6% of participants. GCS were obtained by 78 center dot 1% of participants, with 33 center dot 7% reporting daily wear at the end of follow-up. Mean early Villalta scale was significantly higher in those with PTS (8 center dot 1 +/- 3 center dot 7) compared to those without (2 center dot 6 +/- 2 center dot 7, P<0 center dot 001). Median D-dimer was significantly higher in those with PTS [3260ng/ml, interquartile range (IQR) 8208000ng/ml] compared to those without (1540ng/ml, IQR 8102520ng/ml, P<0 center dot 001). The adjusted odds ratio for every one point increase in early Villalta scale was 1 center dot 78 [95% confidence interval (CI), 1 center dot 192 center dot 64; P=0 center dot 005] and for D-dimer >1910ng/ml it was 2 center dot 71 (95% CI, 1 center dot 057 center dot 03; P=0 center dot 04). These markers could enable targeted counselling regarding GCS for those at high risk of PTS.