Superficial thrombophlebitis and deep vein thrombosis. A controversial association.

BACKGROUND: Superficial thrombophlebitis is a common and benign disease. However, an association with deep vein thrombosis, a more severe condition that requires anticoagulant treatment, has been reported repeatedly with frequencies ranging from 12% to 44%. METHODS: All consecutive records of patients with lower limb superficial thrombophlebitis were retrieved from the laboratory database over a 6-year period (1989-1994), and association with deep vein thrombosis was sought. Also, to detect late events, consultations were registered over a 3-month period after the initial examination. Patients with the association of superficial thrombophlebitis and deep vein thrombosis were also compared with a randomly selected sample of subjects with superficial thrombophlebitis only. RESULTS: Objectively confirmed deep vein thrombosis was detected in 31 patients (5.6%; 95% confidence interval, 3.8%-7.9%). Additional late thromboembolic events were detected in 1.7% of the patients during the 3-month follow-up period. Previous immobilization was more common among patients with deep vein thrombosis associated with superficial phlebitis (11/31, 36%) than among a randomly selected subset of patients with superficial thrombophlebitis only (13/93, 14%), the difference being statistically significant (P < .02). CONCLUSIONS: When large populations of patients with superficial thrombophlebitis are studied, the association with deep vein thrombosis appears rather small. Thus, systematic screening for deep vein thrombosis may not be warranted in the presence of superficial thrombophlebitis unless additional risk factors (eg, immobilization) are present.