To evaluate diagnostic accuracy of wells clinical probability, bedside pocus, and selective d-dimer for early diagnosis of deep vein thrombosis in ICU patients

Introduction: Early and accurate detection of deep vein thrombosis (DVT) is critical in ICU patients, who are at high risk due to immobility and complex comorbidities. Reliance on clinical features alone is often insufficient, and combining diagnostic modalities such as Wells Clinical Probability scoring, point-of-care ultrasound (POCUS), and selective D-dimer testing may optimize patient triage and reduce unnecessary imaging.

Aims and Objectives: This study aims to assess the diagnostic accuracy and efficiency of a combined approach of wells score, bedside POCUS, and selective D-dimer measurement for early DVT detection in adult ICU patients.

Methodology: Adult patients admitted to the ICU, without known DVT at admission, will be prospectively evaluated. Initial risk stratification will be performed of wells Clinical Probability scoring. Bedside POCUS will be used for lower limb venous assessment in moderate/high-risk patients or those with positive D-dimer results. Selective D-dimer testing will help determine the need for further ultrasound in low-risk cases. Diagnostic outcomes will be validated against standard duplex ultrasound findings and clinical follow-up.

Outcome: This study will determine whether a combined strategy can safely and efficiently identify early DVT in ICU patients, potentially reducing the need for comprehensive imaging, lowering costs, and allowing for timely intervention to prevent complications such as pulmonary embolism.