1Research Scholar, Sri Venkateswara College of Pharmacy, Chittoor (A), Research Scholar JNTUA. Email: darlingravi19@gmail.com; ORCID: 0009-0000-7177-9734
2Professor, Sri Venkateswara College of Pharmacy, Chittoor (A). Email: drjothieswari@svcop.in; ORCID: 0000-0002-1352-0756
*Corresponding Author: Dr D. Jothieswari, M Pharm, PhD, Professor, Sri Venkateswara College of Pharmacy, Chittoor-517127. Telephone: +9989165610; Email: drjothieswari@svcop.in
Background: Recurrent deep vein thrombosis (DVT) remains a major contributor to morbidity despite advances in anticoagulation therapy. Conventional risk stratification tools and laboratory biomarkers show limited ability to predict recurrence, while real-time surveillance strategies are rarely implemented in routine clinical care, particularly in resource-limited settings.
Objectives: To evaluate predictors of recurrent DVT, assess the impact of recurrence on disease-specific quality of life, examine adherence and bleeding outcomes, and determine the diagnostic performance of wearable-based point-of-care monitoring for early detection of recurrence.
Methods: This prospective observational cohort study enrolled 169 adults with objectively confirmed proximal lower-limb DVT at a Rvs tertiary care teaching hospital in Chittoor, South India. Participants were followed longitudinally with structured clinical assessments, biomarker evaluation, anticoagulant adherence monitoring, duplex ultrasonography, and wearable-based impedance alerts. Recurrence-free survival was analyzed using Kaplan–Meier methods. Multivariable Cox proportional hazards regression was used to identify independent predictors of recurrence. Diagnostic accuracy of wearable alerts was assessed using receiver operating characteristic (ROC) analysis.
Results: During follow-up, recurrent DVT occurred in 23.1% of patients. No baseline clinical or biochemical variable independently predicted recurrence on multivariable analysis, although Wells score and C-reactive protein showed borderline associations. Recurrence-free survival did not differ significantly across anticoagulant adherence categories (log-rank p = 0.785). Patients with recurrent DVT demonstrated markedly lower VEINES-QOL scores compared with those without recurrence (43.7 ± 6.5 vs. 72.0 ± 7.0). Wearable-based alerts showed excellent diagnostic performance for detecting recurrence (AUC 0.862; sensitivity 84.6%; specificity 87.7%).
Conclusions: In this real-world tertiary care cohort, traditional clinical variables and single baseline biomarkers had limited prognostic value for predicting DVT recurrence. Recurrent events were associated with substantial impairment in quality of life. Wearable-based monitoring demonstrated high diagnostic accuracy and may represent a practical adjunct for early detection and surveillance in high-risk patients.
Keywords: Deep vein thrombosis, recurrence, anticoagulant adherence, biomarkers, quality of life, wearable monitoring.
How to cite this article: Kiran DR, Jothieswari D. A Prospective Evaluation of Recurrence Predictors and Point-Of-Care Monitoring Innovations for Deep Vein Thrombosis in a Tertiary Care Hospital. Int J Drug Deliv Technol. 2026;16(12s): 305-313. DOI: 10.25258/ijddt.16.12s.33
Source of support: Nil.
Conflict of interest: None