Detecting the Association Between Residual Thrombus and Post-thrombotic Classification of Chronic Venous Disease with Range Regression

John      Tuhao Chen; Anthony      James Comerota

doi:10.2174/1574887111207040329

Abstract

This paper addresses a clinical hypothesis detected by the method of range regression, a new statistical method portraying the clinical response via the range of an explanatory variable. For patients with iliofemoral deep venous thrombosis, it has long been clinically suspected that residual thrombus affects the quality of life after catheter-directed thrombolysis. However, such important medical experience has not been validated or scientifically quantified by experimental or observational data. In clinical practice, this association may directly affect the duration of thrombolytic therapy or other attempts at clot removal. In this study, we develop a new regression model to identify how the quantity of clot lysed affects the clarification of chronic venous disease after catheter-directed thrombolysis (a correlated index on postthrombotic quality of life). Bridging clinical insight with statistics by means of medical records of 62 IFDVT patients, the new method reveals that residual thrombus significantly and substantially affects post-thrombotic clarification of chronic venous disease. The conclusion of the new method is confirmed by a conventional logistic regression method when 50% thrombus removal is treated as a categorization threshold. This new approach is applicable to analyze other clinical or medical variables on the treatment of venous diseases.

Keywords: Iliofemoral deep venous thrombosis, catheter-directed thrombolysis, residual thrombus, range regression, CEAP score, linear regression

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