Cut-off values of D-dimer and soluble fibrin for prediction of deep vein thrombosis after orthopaedic surgery

2009 ◽  
Vol 89 (5) ◽  
pp. 572-576 ◽  
Author(s):  
Akihiro Sudo ◽  
Hideo Wada ◽  
Tsutomu Nobori ◽  
Norikazu Yamada ◽  
Masaaki Ito ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Orthopaedic Surgery ◽  
Soluble Fibrin ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

The Clinical Utility of a Rapid Bedside D-dimer Assay for Screening of Deep Vein Thrombosis following Orthopaedic Surgery

1997 ◽  
Vol 78 (04) ◽  
pp. 1300-1301 ◽  
Author(s):  
James D Douketis ◽  
Joanne McGinnis ◽  
Jeffrey S Ginsberg
Keyword(s):  
Deep Vein Thrombosis ◽  
Orthopaedic Surgery ◽  
Clinical Utility ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

Evaluation of soluble fibrin and D-dimer in the diagnosis of postoperative deep vein thrombosis

Biomarkers ◽  
2009 ◽  
Vol 15 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Rui Niimi ◽  
Masahiro Hasegawa ◽  
Akihiro Sudo ◽  
Dequan Shi ◽  
Tomomi Yamada ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Soluble Fibrin ◽  
Vein Thrombosis ◽  
Postoperative Deep Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

scholarly journals Prevalence of acute deep vein thrombosis according to HIV status following major orthopaedic surgery at the University Teaching Hospital, Lusaka, Zambia

2019 ◽  
Vol 23 (3) ◽  
pp. 104-108
Author(s):  
Collin West ◽  
Yakub Mulla ◽  
James Munthali
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Hiv Positive ◽  
Negative Group ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Hiv Seropositive ◽  
D Dimer ◽  
Hiv Negative

Background: Hypercoagulable states and immobilization following lower limb, pelvic, and spinal surgery increases the risk of deep vein thrombosis (DVT). It is also suggested that HIV alone increases the risk of deep vein thrombosis. However no study has been done to determine the prevalence of deep vein thrombosis in HIV seropositive individuals who have undergone lower limb orthopaedic surgery in the Zambian context. We therefore conducted this study to determine the prevalence of deep vein thrombosis in patients who are HIV seropositive in comparison to those who are HIV seronegative after undergoing lower limb orthopaedic surgery. Methods: A total of 42 Patients were enrolled. Of these 23 (54 %) were HIV negative controls and 19 (46 %) were HIV positive patients who underwent lower limb surgery or spinal surgery. Demographic and HIV status data was collected prior to surgery. After surgery a blood sample was tested for fibrinogen degradation products (D-dimer) levels. The patients were then monitored for the development of clinical DVT and those that developed clinical DVT had an ultrasound to confirm the diagnosis. Results: The majority (81%) of the study population were under the age of 50 years. The mean values of D-dimers were 2.33 ± 1.65 μg/ml for the HIV negative group and 2.55 ±1.50 μg/ml for the HIV positive group. The number of positive D-dimer results was similar in the two groups, 94.7% for the HIV cohort and 95.7% in the negative group (X 2 0.19 p=0.89). There was a positive correlation between the D-dimer value and the type of surgery done in both the HIV positive group (R 0.390 p = 0.049) and the HIV negative group (R 0.398 at p = 0.03). In both group’s hip and knee surgeries gave higher values of D-dimers. There was no statistical difference in the occurrence of a positive D-dimer and CD4 count (X2 0.95 p=0.89). The combined prevalence of clinical DVT confirmed by compression ultrasonography in the entire study population was 4.8%. The prevalence in the HIV seropositive group and HIV seronegative groups were 5.3% and 4.3% respectively (X2 0.19 p= 0.89). None of the patients received preoperative DVT prophylaxis due to cost but both patients that developed DVT received antithrombotic treatment. Conclusions: There was no significant difference in the prevalence of DVT between patients who were HIV seronegative and seronegative following major lower limb and spinal orthopaedic surgery. Both groups had raised D-dimer values. Keywords: deep vein thrombosis; HIV; D-dimer; Doppler ultrasound 

scholarly journals Diagnosis of deep vein thrombosis by plasma-soluble fibrin or D-dimer

2005 ◽  
Vol 79 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Satoshi Ota ◽  
Hideo Wada ◽  
Tsutomu Nobori ◽  
Toshihiko Kobayashi ◽  
Midori Nishio ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Soluble Fibrin ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

D-Dimers, Thrombin Antithrombin III Complexes and Prothrombin Fragments 1 + 2: Diagnostic value in Clinically Suspected Deep Vein Thrombosis

1991 ◽  
Vol 65 (01) ◽  
pp. 028-032 ◽  
Author(s):  
B Boneu ◽  
G Bes ◽  
H Pelzer ◽  
P Sié ◽  
H Boccalon
Keyword(s):  
Deep Vein Thrombosis ◽  
Antithrombin Iii ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Predictive Values ◽  
Vein Thrombosis ◽  
High Negative Predictive Value ◽  
Deep Vein ◽  
D Dimer ◽  
Mercury Strain Gauge

SummaryThis study was performed to determine the accuracy of D-Dimer fibrin derivatives, thrombin-antithrombin III (TAT) complexes and prothrombin fragments 1 + 2 (F 1 + 2) determinations for the diagnosis of deep vein thrombosis (DVT). One hundred and sixteen consecutive patients referred to the angiology unit of our hospital for a clinically suspected DVT were investigated. They were submitted to mercury strain gauge plethysmography and to ultrasonic duplex scanning examination; in cases of inconclusive results or of proximal DVT (n = 35), an ascending phlebography was performed. After these investigations were completed, the diagnosis of DVT was confirmed in 34 and excluded in 82. One half of the patients were already under anticoagulant therapy at the time of investigation. The 3 biological markers were assayed using commercially available ELISA techniques and the D-Dimer was also assayed with a fast latex method. The normal distribution of these markers was established in 40 healthy blood donors. The most accurate assay for the diagnosis of DVT was the D-Dimer ELISA which had both a high sensitivity (94%) and a high negative predictive value (95%). The D-Dirner latex, TAT complexes and F 1 + 2 were far less sensitive and provided negative predictive values which ranged between 78 and 85%. In spite of positive and significant correlations between the levels of ihe 3 markers, their association did not improve their overall accuracy for detecting D\/L Therefore, with the exception of the D-Dimer ELISA, these markers were of little value for the diagnosis of DVT in this specific population.

Evaluation of a New Rapid Quantitative D-dimer Assay in Patients with Clinically Suspected Deep Vein Thrombosis

1996 ◽  
Vol 75 (03) ◽  
pp. 412-416 ◽  
Author(s):  
Armando D’Angelo ◽  
Gabriella D’Alessandro ◽  
Loredana Tomassini ◽  
Jean Louis Pittet ◽  
G Dupuy ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Predictive Value ◽  
Cost Savings ◽  
Pretest Probability ◽  
First Episode ◽  
Consecutive Series ◽  
Vein Thrombosis ◽  
Baseline Testing ◽  
Deep Vein ◽  
D Dimer

SummaryThe sensitivity and specificity for deep vein thrombosis (DVT) of a new rapid, quantitative and precise (total imprecision < 10%) D-dimer assay suitable for individual measurements (VIDAS D-DIMER, bio-Merieux, France) were evaluated in a consecutive series of 103 in- and out-patients submitted to serial compression ultrasonography (C-US) for the clinical suspicion of DVT (n = 66) or of DVT recurrence (n = 37) and symptoms lasting from 1 to 15 days. DVT was found in 22 patients at baseline testing and no patient with an initially negative C-US developed vein incompressibility at follow up. The time elapsed from the onset of symptoms was negatively associated with D-dimer levels both in patients with and in those without DVT. In the entire series of patients, the sensitivity of a positive D-dimer test (≥1.0 Μg/ml) for the presence of DVT was 96% (21/22 patients, 95% confidence interval 75-100%) with a specificity of 75% (64-84%), a negative predictive value of 98% (90-100%), a positive predictive value of 51% (35-67%), and an overall accuracy of 80% (70-87%). A normal D-dimer value (0.22 Μg/ml) was observed in one patient with DVT and symptoms lasting from 15 days. The approach of withholding C-US testing in patients with symptoms lasting from less than 11 days and D-dimer levels below the cut-off value was compared to serial C-US testing alone in a cost-effectiveness analysis subdividing the 66 patients with a first episode according to their clinical pretest probability of DVT. Thrombosis was detected in 6.7% of the patients in the low probability group (n = 15), 16.7% of the patients in the moderate probability group (n = 24), 51.9% of the patients in the high probability group (n = 27) and 8.1% of patients with suspected DVT recurrence. Calculated cost-savings for each DVT diagnosed ranged from 5% in the high pretest probability group to 55% in the low pretest probability group and to 77% in patients with suspected DVT recurrence.The safety of avoiding C-US testing in symptomatic patients with a negative D-dimer test should be evaluated in clinical management studies.

D-Dimer Test and Diagnosis of Deep Vein Thrombosis: A Comparative Study of 7 Assays

1996 ◽  
Vol 76 (04) ◽  
pp. 518-522 ◽  
Author(s):  
A Elias ◽  
I Aptel ◽  
B Huc ◽  
J J Chale ◽  
F Nguyen ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Latex Agglutination ◽  
Lower Limbs ◽  
First Episode ◽  
Lower Sensitivity ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

SummaryThe current D-Dimer ELISA methods provide high sensitivity and negative predictive value for the diagnosis of deep vein thrombosis but these methods are not suitable for emergency or for individual determination. We have evaluated the performance of 3 newly available fast D-Dimer assays (Vidas D-Di, BioMerieux; Instant IA D-Di, Stago; Nycocard D-Dimer, Nycomed) in comparison with 3 classic ELISA methods (Stago, Organon, Behring) and a Latex agglutination technique (Stago). One-hundred-and-seventy-one patients suspected of presenting a first episode of deep vein thrombosis were investigated. A deep vein thrombosis was detected in 75 patients (43.8%) by ultrasonic duplex scanning of the lower limbs; in 11 of them the thrombi were distal and very limited in size (<2 cm). We compared the performance of the tests by calculating their sensitivity, specificity, positive and negative predictive value for different cut-off levels and by calculating the area under ROC curves. The concordance of the different methods was evaluated by calculating the kappa coefficient. The performances of the 3 classic ELISA and of the Vidas D-Di were comparable and kappa coefficients indicated a good concordance between the results provided by these assays. Their sensitivity slightly declined for detection of the very small thrombi. Instant IA D-Di had a non-significantly lower sensitivity and negative predictive value than the 4 previous assays; however its performance was excellent for out-patients. As expected, the Latex assay had too low a sensitivity and negative predictive value to be recommended. In our hands, Nycocard D-Dimer also exhibited low sensitivity and negative predictive value, which were significantly improved when the plasma samples were tested by the manufacturer. Thus significant progress has been made, allowing clinical studies to be planned to compare the safety and cost-effectiveness of D-Dimer strategy to those of the conventional methods for the diagnosis of venous thrombosis.

Rapid Quantitative D-dimer Assay and Clinical Evaluation for the Diagnosis of Clinically Suspected Deep Vein Thrombosis

1997 ◽  
Vol 77 (03) ◽  
pp. 602-603 ◽  
Author(s):  
J Y Borg ◽  
H Lévesque ◽  
N Cailleux ◽  
C Franc ◽  
M F Hellot ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Evaluation ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

scholarly journals Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Xiang Wu ◽  
Jiang Hui Qing ◽  
Yao Yao ◽  
Dong Yang Chen ◽  
Qing Jiang
Keyword(s):  
Deep Vein Thrombosis ◽  
Odds Ratio ◽  
Joint Arthroplasty ◽  
Receiver Operating Curve ◽  
Multiple Logistic Regression ◽  
Vein Thrombosis ◽  
Specificity And Sensitivity ◽  
Knee And Hip Arthroplasty ◽  
Deep Vein ◽  
D Dimer

Abstract Purpose To compare the specificity and sensitivity of preoperative D-dimer and age-adjusted D-dimer value for predicting the incidence of the DVT preoperatively in total joint arthroplasty (TJA) patients. Methods We enrolled 406 patients finally above 50 years old. Everyone had done ultrasonography bedside, and D-dimer concentrations were collected before surgery. The D-dimer and age-adjusted D-dimer cut-off was calculated by multiple logistic regression and receiver operating curve (ROC) analyses. Results A total of 39 patients had found asymptomatic deep vein thrombosis (DVT) by ultrasonography. The age (odds ratio [OR] 1.067; p = 0.003) and D-dimer (OR 1.331; p = 0.025) were related to the existence of DVT. For conventional D-dimer and age-adjusted D-dimer value, the area under the curves (AUCs) were 0.685 (0.499–0.696) and 0.795 (0.611–0.881), respectively. Conclusion Compared to traditional D-dimer, age-adjusted D-dimer showed better performance in screening DVT, which was useful clinically.

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