Risk Factors for Deep Vein Thrombosis after Orthopedic Surgery and the Diagnostic Value of D-Dimer

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.

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Study on the Risk Factors of Preoperative Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211002900 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110029

Author(s):

Wenjie Chang ◽

Bin Wang ◽

Qiwei Li ◽

Yongkui Zhang ◽

Wenpeng Xie

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Lower Extremity ◽

Color Doppler ◽

Fracture Site ◽

Vein Thrombosis ◽

Lower Extremity Fracture ◽

Extremity Fracture ◽

Deep Vein ◽

D Dimer

Objective: The objective of this work is to discuss and analyze the related factors of lower extremity fracture complicated by preoperative deep vein thrombosis (DVT). Methods: A total of 11,891 patients with closed fractures of lower extremities were selected. By analyzing each patient’s gender, age, presence or absence of diabetes and hypertension, preoperative plasma D-dimer level, and color Doppler ultrasound of the lower extremity vein, the pertinent factors of the patients with lower extremity fractures complicated by preoperative DVT were analyzed. Results: A total of 578 with preoperative DVT were detected, displaying a total incidence of 4.86%. All patients were categorized into either the DVT group or non-DVT group. The results demonstrate that there were statistically significant differences between the 2 groups in age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level ( P < 0.05). Logistic multivariate analysis revealed that age, the presence of diabetes, and the preoperative plasma D-dimer level of patients were independent risk factors for lower extremity fracture complicated by DVT. Conclusion: Age, the presence of diabetes, the fracture site, and increased D-dimer levels were found to be potential risk factors and indicators for preoperative DVT in patients with lower extremity fractures. In addition, the preoperative plasma D-dimer level has certain guiding significance for the prediction of venous thrombosis after lower extremity fracture, which is conducive to the early prediction and diagnosis of DVT, but it often must be followed with good clinic acumen and examinations.

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Deep Vein Thrombosis in the Uninjured Limb in Patients with Lower Extremity Fractures: A Retrospective Study

BioMed Research International ◽

10.1155/2020/1647617 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Peng-Fei Wang ◽

Jia-Hao Li ◽

Chen Fei ◽

Zhi Li ◽

Chao Ke ◽

...

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Lower Extremity ◽

Doppler Ultrasonography ◽

Vein Thrombosis ◽

Independent Risk Factors ◽

Level 1 ◽

Deep Vein ◽

Actual Incidence ◽

D Dimer

Objective. This study is aimed at investigating the incidence of deep vein thrombosis (DVT) in the uninjured limb during hospitalization and 1 month after surgery in patients with lower extremity fractures. Methods. We collected the clinical data of patients with lower extremity fractures in Xi’an Honghui Hospital. Doppler ultrasonography was used to diagnose DVT. According to the results of ultrasonography, the patients were divided into two groups: uninjured limb with DVT group and uninjured limb without DVT group. Results. A total of 494 patients who met all inclusion criteria were included in this study. The incidence rate of DVT in the uninjured limb was 19.84% and 18.83% during hospitalization and 1 month after surgery, respectively. Age (OR=1.035, 95% CI: 1.013–1.059; P=0.002) and D-dimer level 1 day after surgery (OR=1.065, 95% CI: 1.030–1.102; P<0.001) were independent risk factors for DVT during hospitalization. Similarly, age (OR=1.045, 95% CI: 1.021–1.070; P<0.001) and D-dimer level 1 day after surgery (OR=1.048, 95% CI: 1.014–1.083; P=0.006) were independent risk factors for DVT 1 month after surgery. During hospitalization and 1 month after surgery, 15.79% and 12.35% of patients had double lower limb thrombosis and 4.04% and 6.48% of patients had DVT in the uninjured limb only, respectively. Conclusion. The actual incidence of DVT in the uninjured limb in patients with lower extremity fractures cannot be ignored despite the use of anticoagulants for prevention or treatment during hospitalization. We should also be aware of DVT in the uninjured limb while focusing on DVT in the injured limb.

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D-dimer and Factor VIII are Independent Risk Factors for Recurrence After Anticoagulation Withdrawal for a First Idiopathic Deep Vein Thrombosis

Journal of Vascular Surgery ◽

10.1016/j.jvs.2009.03.017 ◽

2009 ◽

Vol 49 (5) ◽

pp. 1357

Author(s):

B. Cosmi ◽

C. Legnani ◽

M. Cini

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Factor Viii ◽

Vein Thrombosis ◽

Risk Factors For Recurrence ◽

Independent Risk Factors ◽

Deep Vein ◽

D Dimer

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Diagnostic Value of Plasma Thrombin-Antithrombin III Complex and D-Dimer Concentration in Patients with Varicose Veins for Exclusion of Deep-Vein Thrombosis

Thrombosis Research ◽

10.1016/s0049-3848(98)00081-4 ◽

1998 ◽

Vol 91 (2) ◽

pp. 101-104 ◽

Cited By ~ 6

Author(s):

Tomio Kawasaki ◽

Nobutoshi Shinoki ◽

Shin-ichi Iwamoto ◽

Hironobu Fujimura ◽

Norihide Yoshikawa ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Antithrombin Iii ◽

Varicose Veins ◽

Diagnostic Value ◽

Vein Thrombosis ◽

Deep Vein ◽

Thrombin Antithrombin Iii Complex ◽

D Dimer

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Factors affecting the recurrence in patients with venous thromboembolism: A retrospective cohort study

Turkish Journal of Thoracic and Cardiovascular Surgery ◽

10.5606/tgkdc.dergisi.2021.20679 ◽

2021 ◽

Vol 29 (3) ◽

pp. 384-390

Author(s):

Yasemin Ateş ◽

Züleyha Bingöl ◽

Gülfer Okumuş ◽

Orhan Arseven

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Pulmonary Thromboembolism ◽

First Year ◽

Factors Affecting ◽

Vein Thrombosis ◽

Hereditary Risk ◽

Deep Vein ◽

D Dimer

Background: The aim of the study was to evaluate the frequency of recurrence and the risk factors for recurrence in patients who were diagnosed with venous thromboembolism. Methods: Between January 2005 and January 2015, a total of 412 venous thromboembolism patients (164 males, 248 females; mean age: 53.5±16.6 years; range: 19 to 95 years) were retrospectively analyzed. The demographics, underlying risk factors, comorbidities, imaging findings, and treatment data of the patients were recorded. Results: At least one transient/permanent risk factor was found in 341 (82.7%) of the index events, and the other 71 (17.2%) were idiopathic. Recurrence developed in 76 (18.4%) of the patients. The duration of the treatment in the first event was significantly longer in recurrent cases (p=0.007). The recurrence rate in patients diagnosed with only deep vein thrombosis or patients diagnosed with pulmonary thromboembolism + deep vein thrombosis was significantly higher than the patients diagnosed with only pulmonary thromboembolism (24% vs. 14.2%, respectively; p=0.007). The rate of idiopathic venous thromboembolism was higher in recurrent cases than in non-recurrent cases (26.3% vs. 15.2%, respectively; p=0.028). At the end of the first year, the mean D-dimer levels were higher in recurrent cases (p=0.034). Hereditary risk factors were also higher in recurrent cases (39.5% vs. 19.3%, respectively; p=0.031). There was no significant correlation between recurrence and mortality. Conclusion: The presence of deep vein thrombosis, idiopathic events, high D-dimer levels at the end of the first year and hereditary risk factors seem to be associated with recurrence.

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Diagnostic Value of Neutrophil Lymphocyte Ratio and D-Dimer as Biological Markers of Deep Vein Thrombosis in Patients Presenting with Unilateral Limb Edema

Journal of Blood Medicine ◽

10.2147/jbm.s291226 ◽

2021 ◽

Vol Volume 12 ◽

pp. 313-325

Author(s):

Ikhwan Rinaldi ◽

Rachmat Hamonangan ◽

Mohamad Syahrir Azizi ◽

Rahmat Cahyanur ◽

Fadila Wirawan ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Biological Markers ◽

Diagnostic Value ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Vein Thrombosis ◽

Limb Edema ◽

Deep Vein ◽

D Dimer

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A Retrospective cohort study on the risk factors of deep vein thrombosis (DVT) for patients with traumatic fracture at Honghui Hospital

BMJ Open ◽

10.1136/bmjopen-2018-024247 ◽

2019 ◽

Vol 9 (3) ◽

pp. e024247 ◽

Cited By ~ 3

Author(s):

Wenjuan Zhang ◽

Ying Huai ◽

Wei Wang ◽

Kaiyue Xue ◽

Lei Chen ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Deep Vein Thrombosis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Clinical Laboratory ◽

Vein Thrombosis ◽

Traumatic Fracture ◽

Deep Vein ◽

D Dimer

ObjectiveTo explore the risk factors of perioperative deep vein thrombosis (DVT) in patients with traumatic fracture after orthopaedic surgery and their potential diagnostic values in clinical.DesignRetrospective cohort study.SettingClinical Laboratory of Honghui Hospital, Xi’an JiaoTong University College of Medicine, Xi’an, Shaanxi, China.Materials and methodsA retrospective cohort study was conducted with surgically treated fracture patients in Honghui Hospital from 1 May 2016 to 31 February 2017.χ2test, independent sample t test and regression analysis were applied to examine the correlation between perioperative DVT and the factors of preoperative time, fracture sites, D-dimer value and chronic diseases (hypertension, diabetes and coronary disease).Results462 patients were enrolled for analysis. The preoperative time of patients with DVT was significantly longer than that of non-DVT patients (7.14±5.51 vs 5.45±3.75) (P<0.01).χ2test showed the significant differences in the rate of DVT among patients with different fracture sites (P<0.01). By the receiver-operating characteristic curve analysis, the cut-off value of preoperative D-dimer and postoperative D-dimer in diagnosing perioperative DVT was 4.01 µg/mL and 5.03 µg/mL, respectively. Area under the curve was 0.593 (95% CI 0.533 to 0.652) and 0.728 (95% CI 0.672 to 0.780), respectively. The sensitivity and specificity of preoperative D-dimer for DVT diagnosis were 71.30% and 44.83%, and as for postoperative D-dimer were 63.90% and 70.51%.ConclusionsFracture site was correlated to the incidence of DVT; prolonged preoperative time and increased D-dimer value were independent risk factors for DVT in patients with lower extremity traumatic fractures.

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D-Dimer Level Significance for Deep Vein Thrombosis Screening in The Third Trimester : A Retrospective Study

10.21203/rs.3.rs-753804/v1 ◽

2021 ◽

Author(s):

Keisuke Miyamoto ◽

Hiroaki Komatsu ◽

Masayo Okawa ◽

Yuki Iida ◽

Daiken Osaku ◽

...

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Lower Limb ◽

Third Trimester ◽

Vein Thrombosis ◽

The Third ◽

Deep Vein ◽

D Dimer ◽

Compression Ultrasonography

Abstract BackgroundVenous thromboembolism often develops after surgery and childbirth, resulting in death in some cases. Although early deep vein thrombosis (DVT) detection can predict pulmonary thromboembolism, there is no early screening method for DVT in pregnant women. Lack of consensus regarding significance or setting and cut-off value interpretation of D-dimer levels further impedes venous thromboembolism screening in pregnant women.This study aimed to examine the utility of third-trimester serum D-dimer levels for screening test for DVT during pregnancy.to determine the frequency of asymptomatic DVT using lower-limb compression ultrasonography.MethodsThis single-center retrospective study included 497 pregnant women who underwent elective cesarean section at term in our hospital between January 2013 and December 2019. Serum D-dimer levels were preoperatively measured at 32–37 gestation weeks. The presence or absence of DVT in patients with serum D-dimer levels ≥ 3.0 µg/ml, the cut-off value, was examined using compression ultrasonography. In all patients, the presence or absence of clinical venous thrombosis (symptoms such as lower-limb pain, swelling, and heat sensation) was examined within 4 postoperative weeks.The Royal College of Obstetricians and Gynecologists Guideline 2015 was referred to determine risk factors for the onset of venous thrombosis during pregnancy. Among those, we examined the risk factors for DVT that result in high D-dimer levels during pregnancy.ResultsThe median age and body mass index were 35 (20–47) years and 21.2 (16.4–41.1) kg/m2, respectively. Further, the median gestational age and D-dimer levels were 37 weeks and 2.1 (0.2–16.0) µg/ml, respectively. Compression ultrasonography was performed on 135 (26.5%) patients with a D-dimer level ≥3.0 µg/ml, with none of the patients showing DVT. All patients were followed up for 4 postoperative weeks, with none presenting with venous thromboembolism. Multivariate analysis showed that hypertensive disorders of pregnancy is an independent risk factor for venous thromboembolism that causes high D-dimer levels (odds ratio: 2.48, 95% confidence interval: 1.05–6.50, P=0.04).ConclusionThere may be low utility in screening for DVT using D-dimer levels in the third trimester. Further, prepartum asymptomatic DVT has a low frequency, indicating the low utility of compression ultrasonography.Trial registrationInstitutional Review Board of Tottori University Hospital (IRB no. 20A149).

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Incidence and Risk Factors of Deep Vein Thrombosis in Hospitalized COVID-19 Patients

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029620953217 ◽

2020 ◽

Vol 26 ◽

pp. 107602962095321 ◽

Cited By ~ 1

Author(s):

Yuan Yu ◽

Jie Tu ◽

Bingxin Lei ◽

Huaqing Shu ◽

Xiaojing Zou ◽

...

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Incidence Rate ◽

Vein Thrombosis ◽

Number Of Patients ◽

Proximal Extremity ◽

High Level ◽

Deep Vein ◽

D Dimer ◽

Extremity Veins

Deep vein thrombosis (DVT) is prevalent in patients with coronavirus disease 2019 (COVID-19). However, the risk factors and incidence rate of DVT remains elusive. Here, we aimed to assess the incidence rate and risk factors of DVT. All patients diagnosed with COVID-19 and performed venous ultrasound by ultrasound deparment between December 2019 and April 2020 in Wuhan Jin Yin-tan hospital were enrolled. Demographic information and clinical features were retrospectively collected. Notably, a comparison between the DVT and the non-DVT groups was explored. The incidence rate of venous thrombosis was 35.2% (50 patients out of 142). Moreover, the location of thrombus at the proximal extremity veins was 5.6% (n = 8), while at distal extremity veins was 35.2% (n = 50) of the patients. We also noted that patients with DVT exhibited a high level of D-dimer (OR 10.9 (95% CI, 3.3-36.0), P < 0.001), were admitted to the intensive care unit (OR 6.5 (95% CI, 2.1-20.3), P = 0.001), a lower usage of the anticoagulant drugs (OR 3.0 (95% CI, 1.1-7.8), P < 0.001). Finally, this study revealed that a high number of patients with COVID-19 developed DVT. This was observed particularly in critically ill patients with high D-dimer levels who required no anticoagulant medication.

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