Abstract
Objective: This scoping review aims to evaluate the sensitivity and specificity of various screening tools for deep vein thrombosis (DVT) of the lower limbs in critically ill patients. Methods: We conducted a systematic search of studies published between 2000 and September 2024 using databases including PubMed, MEDLINE, the Hanoi Medical University Digital Library, and the National Digital Library of Vietnam. A total of 24 studies involving 19,771 critically ill patients were included. Data extraction and synthesis followed PRISMA-ScR guidelines. Results: Compression ultrasonography (CUS), particularly 3-point CUS, demonstrated high sensitivity (63%–86%) and specificity (96%–98%) compared to Doppler ultrasound (DUS), considered the gold standard in clinical practice. D-dimer testing showed variable sensitivity (55.9%–97.9%) and low specificity (3%–72.2%), but its diagnostic value improved when adjusted for age and combined with the Wells clinical score. The modified Wells score alone showed low sensitivity (30%) but high specificity (97.5%). The incidence of asymptomatic DVT was notably high (74%–95.6%), highlighting the necessity of active screening strategies. Conclusion: DUS remains the most practical and effective screening tool for DVT in intensive care settings. Although venography is the gold standard, its limited feasibility in critically ill patients restricts its routine use. An integrated approach combining clinical assessment, D-dimer testing, and bedside ultrasound may enhance early detection and reduce thromboembolic complications in this high-risk population.
