Abstract
Introduction D-dimers are products of fibrin being degraded by thrombin, factor XIIIa and plasmin. Their blood concentration is used in clinical diagnostics for venous thromboembolism (VTE) which involves deep vein thrombosis (DVT) and pulmonary embolism (PE). Purpose Surgical operations within the femoral bone are one of the most often performed ones in orthopedic wards. In order to determine an impact of bone injury on the risk of occurrence of a thromboembolic disease we compared the preoperative concentration of D-dimers between a group of patients hospitalized due to femur fracture and a group of patients hospitalized due to coxarthrosis or gonarthrosis. Material and methods The study involved overall 404 patients, divided into two groups. The first group enrolled 283 patients who underwent elective surgery on the femoral bone: total hip replacement (THR) and total knee replacement (TKR) due to osteoarthritis of large joints. The second group enrolled 121 patients who underwent surgery due to femoral fracture. All patients underwent a physical examination for an occurrence of varicose veins in lower limbs. No clinical features of venous thromboembolism were found in patients qualified for the study, based on examination of the venous system in lower limbs, which was supplemented by ultrasound examination. Preoperative blood concentrations of D-dimers were measured in all participants. Results In patients undergoing scheduled joint replacement surgery due to coxarthrosis or gonarthrosis D-dimers concentrations ranged between 122 and 7712 ng/mL, with a mean of 822.3 ng/mL (SD 811.2 ng/mL). It was markedly lower than these found in patients with femur fracture: they ranged from 23.6 to 48340 ng/mL, mean 8793.2 ng/mL (SD ± 10358.6 ng/mL). Conclusions It is suggested that elevated D-dimers levels observed in patients with femur fracture are not associated with an increased risk of occurrence of a thromboembolic disease.
Factor XIIIA-V34L and Factor XIIIB-H95R Gene Variants: Effects on Survival in Myocardial Infarction Patients