scholarly journals A Retrospective Analysis of the Coagulation Dysfunction in COVID-19 Patients

2020 ◽  
Vol 26 ◽  
pp. 107602962096486
Author(s):  
Xu Chen ◽  
Qinghua Wang ◽  
Min Xu ◽  
Chengbin Li
Keyword(s):  
Prothrombin Time ◽  
Retrospective Analysis ◽  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
Thrombin Time ◽  
Coagulation Function ◽  
Severe Group ◽  
New Biomarkers ◽  
Coagulation Dysfunction ◽  
D Dimer

To discuss the coagulation dysfunction in COVID-19 patients and to find new biomarkers to separate severe COVID-19 patients from mild ones. We use a retrospective analysis of 88 COVID-19 patients, and compare the coagulation function between severe and mild groups. We found the prothrombin time (PT), thrombin time (TT), D-dimer were significantly higher in the severe group ( P < 0.05), and the highest area under the curve (AUC) is 0.91 for D-dimer, while the AUC of PT and TT were 0.80 and 0.61 respectively. We identified that D-dimer has a better value in predicting patients who are likely to develop into severe cases, with the sensitivity and specificity were 84.4% and 88.8%, respectively. D-dimer may be a good biomarker to separate the severe COVID-19 patients from the mild ones.

scholarly journals D-Dimer and Prothrombin Time Are the Significant Indicators of Severe COVID-19 and Poor Prognosis

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Hui Long ◽  
Lan Nie ◽  
Xiaochen Xiang ◽  
Huan Li ◽  
Xiaoli Zhang ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Early Stage ◽  
Ct Imaging ◽  
Coagulation Disorder ◽  
Thrombin Time ◽  
Clinical Classification ◽  
Dynamic Changes ◽  
Lab Test ◽  
Coagulation Dysfunction ◽  
D Dimer

Objective. To investigate the value of coagulation indicators D-dimer (DD), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (Fg) in predicting the severity and prognosis of COVID-19. Methods. A total of 115 patients with confirmed COVID-19, who were admitted to Tianyou Hospital of Wuhan University of Science and Technology between January 18, 2020, and March 5, 2020, were included. The dynamic changes of DD, PT, APTT, and Fg were tested, and the correlation with CT imaging, clinical classifications, and prognosis was studied. Results. Coagulation disorder occurred at the early stage of COVID-19 infection, with 50 (43.5%) patients having DD increased and 74 (64.3%) patients having Fg increased. The levels of DD and Fg were correlated with clinical classification. Among 23 patients who deceased, 18 had DD increased at the first lab test, 22 had DD increased at the second and third lab tests, and 18 had prolonged PT at the third test. The results from ROC analyses for mortality risk showed that the AUCs of DD were 0.742, 0.818, and 0.851 in three times of test, respectively; PT was 0.643, 0.824, and 0.937. In addition, with the progression of the disease, the change of CT imaging was closely related to the increase of the DD value (P<0.01). Conclusions. Coagulation dysfunction is more likely to occur in severe and critically ill patients. DD and PT could be used as the significant indicators in predicting the mortality of COVID-19.

scholarly journals ASSESSMENT OF COAGULATION PROFILE IN PATIENTS WITH LIVER CIRRHOSIS AND ATRIAL FIBRILLATION

2021 ◽  
Vol 121 (1) ◽  
pp. 22-31
Author(s):  
Alіna Baylo ◽  
Vadym Shypulіn ◽  
Volodymyr Chernyavskyi ◽  
Luiza Parunyan
Keyword(s):  
Atrial Fibrillation ◽  
Liver Cirrhosis ◽  
Prothrombin Time ◽  
Partial Thromboplastin Time ◽  
International Normalized Ratio ◽  
Activated Partial Thromboplastin Time ◽  
Fibrinolytic System ◽  
Thrombin Time ◽  
Group I ◽  
D Dimer

The comorbid course of liver cirrhosis and atrial fibrillation causes higher levels of hospitalizations, mortality and ischemic stroke. According to current data, hemostasis in patients with liver cirrhosis is in a rebalanced dynamic state, but there are no data on the effect of atrial fibrillation on the hemostasis in patients with liver cirrhosis. Aims of the study. To assess abnormalities in primary, secondary haemostasis and fibrinolytic system in patients with liver cirrhosis and atrial fibrillation by using standard laboratory coagulation parameters and to investigate their changes depending on the stage of liver cirrhosis A, B, C according to Child-Pugh score. Materials and methods. A cross-sectional prospective study was conducted with the inclusion of 106 patients aged 42 to 83 years: group I (n = 70) - with liver cirrhosis and atrial fibrillation, II (n = 36) - with liver cirrhosis, which were distributed depending on the Child-Pugh score stages of cirrhosis and 20 healthy individuals. The levels of platelets, activated partial thromboplastin time, international normalized ratio, prothrombin time, thrombin time, fibrinogen, D-dimer were assessed on a Steellex M200 coagulometer. Statistical analysis (IBM SPSS Statistics) was performed. Results. The level of platelets in patients of group I was reduced by 37.4% (200 ± 8.33 vs. 274.7 ± 3.4; p,000.001), an activated partial thromboplastin time was prolonged by 38.6% (44.35 ± 1.39 vs. 32.01 ± 0.63, p˂0.001), prothrombin time was prolonged by 73.5% (19.4 ± 0.87 vs. 11.18 ± 0.53, p˂0.001), thrombin time was prolonged by 2.07 (25, 7 ± 1.31 vs. 12.4 ± 0.66, p˂0.001), the international normalized ratio was increased by 24.3% (1.38 ± 0.04 vs.1.11 ± 0.01, p˂0.001) compared to control. The fibrinogen level was 20.9% higher (4.17 ± 0.17 vs. 3.45 ± 0.11, p˂0.001) than in control group and was 83.7% higher (4.17 ± 0.17 vs. 2.27 ± 0.13, p˂0.001) than in group II. The D-dimer level was 83% higher than in control (675 ± 22.3 vs. 368.8 ± 21.85, p˂0.001) and 44% higher (675 ± 22.3 vs. 469 ± 37.18, p ˂0.001) compared with group II. Conclusions. In patients with liver cirrhosis and atrial fibrillation abnormalities of primary hemostasis are detected due to decrease of platelets on the background of portal hypertension. At the secondary stage of hemostasis indicators of external and internal coagulation mechanisms are prolonged due to the reduced synthesis of coagulation factors by the liver. Increased level of fibrinogen is determined at the stage of compensated and subcompensated cirrhosis with a gradual decrease at the stage of decompensation. The high activity of the fibrinolytic system is observed due to increase in the D-dimer levels, which may indicate a prothrombotic state in these patients.

scholarly journals Coagulation Dysfunction and Hematological Changes in 633 Patients with COVID-19

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 22-23
Author(s):  
Mo Yang ◽  
Huixia Deng ◽  
Liuming Yang ◽  
Liang Li ◽  
Jieyu Ye ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Pulmonary Manifestations ◽  
Hematological Changes ◽  
Coagulation Dysfunction ◽  
Case Data ◽  
D Dimer

Background: A previously unknown beta-coronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. The virus was named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the international committee for the classification of viruses (ICTV). The disease caused by this virus was named as coronavirus disease 2019 (COVID-19). In addition to pulmonary manifestations, hematological changes such as lymphocytopenia, thrombocytopenia, and coagulation dysfunction can also be found in COVID-19 patients, and the mechanism is still unclear. Case data and methods: A total of 633 COVID-19 patients from Wuhan hospital of China were retrospectively analyzed. Clinical case data of all patients were collected, including gender, age, chronic underlying diseases, outcome, and blood laboratory test results. The hematological features of COVID-19 patients and the factors affecting their outcome were analyzed. Results: Of 633 patients with COVID-19, the median age was 62 years (interquartile range, IQR, 51.0-70.0) and 330 (52%) were men. Lymphocytopenia (lymphocyte count, 1.0 ×109 / L [IQR, 0.7-1.4]) occurred in 317/607 patients (52%), thrombocytopenia (platelet count &lt;100 × 109/ L) occurred in 14/62 death patients (23%), prolonged prothrombin time (13.8 seconds [IQR, 13.1-15.1]) in 289/486 patients (59%), increased D-Dimer level (0.7 mg/L[IQR, 0.2-2.9]) in 230/411 patients (57%) and increased C-reactive protein levels (10.7 mg/L [IQR, 2.2-49.7]) in 217/426 patients (51%) . Compared with the survival patients, death patients have higher white blood cell count (11.7 × 109/L [IQR, 8.4 to 15.6]), neutrophil count (10.8 × 109/L [IQR, 7.8 to 13.9]), neutrophil count/lymphocyte count (20.5 [IQR, 12.4-34.2]), activated partial thromboplastin time (36.8 seconds [IQR, 31.3-42.3]), prothrombin time (17.1 seconds [IQR, 14.7 to 19.7]), D-Dimer level (4.6 mg/L [IQR, 1.0 to 7.8]), C-reactive protein level (111.8 mg/L (IQR, 53.1 to 196.6), and low lymphocyte count (0.5 × 109/L [IQR, 0.3 to 0.7]). The results of logistic multivariate regression analysis showed that age, neutrophil count, prothrombin time, and C-reactive protein were risk factors for patients with COVID-19. Conclusion: Hematological changes are common in patients with COVID-19. The early stage of the disease is mainly characterized by lymphocytopenia, thrombocytopenia, and the late stage may be characterized by more severe lymphocytopenia, even neutrophils elevation, elevated C-reactive protein, and severe coagulation disorder. The pathogenesis may be mediated by a direct viral infection and/or indirect immunopathology. Disclosures No relevant conflicts of interest to declare.

scholarly journals Prominent changes in blood coagulation of patients with SARS-CoV-2 infection

2020 ◽  
Vol 58 (7) ◽  
pp. 1116-1120 ◽  
Author(s):  
Huan Han ◽  
Lan Yang ◽  
Rui Liu ◽  
Fang Liu ◽  
Kai-lang Wu ◽  
...  
Keyword(s):  
Blood Coagulation ◽  
Degradation Products ◽  
Control Group ◽  
Thrombin Time ◽  
Healthy Controls ◽  
Time Activity ◽  
Coagulation Function ◽  
Number Of Patients ◽  
Novel Coronavirus ◽  
D Dimer

AbstractBackgroundAs the number of patients increases, there is a growing understanding of the form of pneumonia sustained by the 2019 novel coronavirus (SARS-CoV-2), which has caused an outbreak in China. Up to now, clinical features and treatment of patients infected with SARS-CoV-2 have been reported in detail. However, the relationship between SARS-CoV-2 and coagulation has been scarcely addressed. Our aim is to investigate the blood coagulation function of patients with SARS-CoV-2 infection.MethodsIn our study, 94 patients with confirmed SARS-CoV-2 infection were admitted in Renmin Hospital of Wuhan University. We prospectively collect blood coagulation data in these patients and in 40 healthy controls during the same period.ResultsAntithrombin values in patients were lower than that in the control group (p < 0.001). The values of D-dimer, fibrin/fibrinogen degradation products (FDP), and fibrinogen (FIB) in all SARS-CoV-2 cases were substantially higher than those in healthy controls. Moreover, D-dimer and FDP values in patients with severe SARS-CoV-2 infection were higher than those in patients with milder forms. Compared with healthy controls, prothrombin time activity (PT-act) was lower in SARS-CoV-2 patients. Thrombin time in critical SARS-CoV-2 patients was also shorter than that in controls.ConclusionsThe coagulation function in patients with SARS-CoV-2 is significantly deranged compared with healthy people, but monitoring D-dimer and FDP values may be helpful for the early identification of severe cases.

Thromboelastography - Viscoelastic Haemostatic Assay (VHA) Versus Routine Plasma Based Coagulation Parameters in Trauma Patients to Detect Coagulopathy within 24 Hrs After Injury

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5248-5248
Author(s):  
Bhaumik Arvindkumar Shah ◽  
Arulselvi Subramanium ◽  
Subhadra Sharma ◽  
Deepak Agrawal ◽  
Gaurav Chhabra ◽  
...  
Keyword(s):  
Head Injury ◽  
Prothrombin Time ◽  
Whole Blood ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time ◽  
Trauma Patients ◽  
Thrombin Time ◽  
Coagulation Parameters ◽  
Conventional Methods ◽  
D Dimer

Abstract Abstract 5248 In India trauma related deaths occur every 1.9 minutes. Mortality in severe traumatic injury (ISS>16) is six times higher in developing country like India. Coagulopathy is observed in almost 25– 30% of trauma patients which itself is an independent risk factor for haemorrhage. Coagulopathy detected early after injury is indicative of injury severity and itself is a prognostic factor for mortality. Aim To find out the usefulness of thromboelastography (TEG) in detecting coagulopathy in contrast to conventional methods of plasma based standard coagulation parameters (PT, aPTT, TT, fibrinogen, D-dimer) Objective To detect coagulopathy early by TEG in trauma patients within 24 hrs after injury which can be useful to guide haemostatic therapies to reduce mortality. Materials and methods Patients admitted to trauma casualty were studied within 24 hrs after injury. Native whole blood was withdrawn through venepuncture appropriately in syringe using 21G needle and TEG was performed within 2 mins. Blood was also collected in citrated tube to assess standard coagulation parameters (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, D-dimer) and also by means of thromboelastography. Results Patients (n=87,New ISS-24.78(mean)) admitted to J.P.N Apex trauma centre casualty from 1st April,2011 to 31st July,2011 were studied. The cases included in the study were isolated head injury (n=40, NISS-25.87(mean)), multiple trauma with head injury (n=13,NISS – 30.69 (mean)) and trauma other than head injury (n=34, NISS-21.24 (mean)).Thromboelastography was performed using whole blood (n=69) and citrated blood (n=18). Coagulation tests were performed on all 87 patients using both TEG and conventional coagulation parameters. Total 52 patients showed coagulopathy by TEG and only 14 patients showed coagulopathy by standard coagulation parameters (prothrombin time, activated partial thromboplastin time). Only in 10 cases coagulopathy was detected by both methods. 4 patients showed coagulopathy only by conventional methods while 42 patients showed coagulopathy by only Thromboelastography (TEG). To find out whether there is any stastistical significance in the observed apparently better result by TEG, McNemar Test was carried out and P value was <0.0001. Conclusion Thromboelastography could be a better technique as compared to conventional measurements of PT, aPTT, TT, Fibrinogen, D-dimer in early detection of coagulopathy in trauma patients. Disclosures: No relevant conflicts of interest to declare.

Serum cholinesterase on admission as a predictor of COVID-19 pneumonia severity and mortality

2020 ◽  
Author(s):  
Kento Nakajima ◽  
Takeru Abe ◽  
Ryo Saji ◽  
Fumihiro Ogawa ◽  
Hayato Taniguchi ◽  
...  
Keyword(s):  
Prediction Accuracy ◽  
Area Under The Curve ◽  
Serum Cholinesterase ◽  
C Reactive Protein ◽  
Survival Group ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Interaction Terms ◽  
Severe Group ◽  
D Dimer

Abstract Background Although some predictors of COVID-19 pneumonia severity and mortality have been identified, much of the pathophysiology of this emerging infectious disease remains unclear. We hypothesized that a patient’s cholinesterase level on admission could predict COVID-19 pneumonia severity and mortality. Methods We retrospectively collected data of 26 COVID-19 pneumonia patients from February–May 2020. Outcomes were aggravation of symptoms and in-hospital mortality. We compared receiver operating curves of cholinesterase, C-reactive protein, lymphocytes, albumin, D-dimer, and PaO2/FiO2 ratio and examined prediction accuracy. Regarding the interaction between cholinesterase and other variables, each independent variable was divided into two groups using cutoff values, and interaction terms were created. Results Cholinesterase levels on admission were significantly lower in the severe group than in the mild-to-moderate group (326 vs. 218 IU/L, p = 0.006; area under the curve: 0.81; 95% confidence interval 0.61–0.94). When comparing the area under the curve, cholinesterase was comparable to C-reactive protein, albumin, lymphocytes, and PaO2/FiO2 ratio other than D-dimer in the prediction accuracy of severe cases and mortality. Cholinesterase levels on admission were significantly lower in the death group than in the survival group (274 vs. 187.5 IU/L, p = 0.028; area under the curve: 0.79; 95% interval 0.58–0.93). Regarding the interaction between cholinesterase and established predictors, the prediction accuracy of both severity and death was higher when cholinesterase was combined with each predictor than when cholinesterase was used alone. Conclusions Cholinesterase may reflect the disease state of COVID-19 pneumonia, suggesting that a patient’s cholinesterase level on admission may be useful as a predictor of severity and prognosis.

scholarly journals Prevalence and Impact of Coagulation Dysfunction in COVID-19 in China: A Meta-Analysis

2020 ◽  
Vol 120 (11) ◽  
pp. 1524-1535 ◽  
Author(s):  
Shanen Jin ◽  
Yiyang Jin ◽  
Bai Xu ◽  
Jun Hong ◽  
Xianghong Yang
Keyword(s):  
Platelet Count ◽  
Confidence Interval ◽  
Prothrombin Time ◽  
Disseminated Intravascular Coagulation ◽  
Poor Prognosis ◽  
Meta Analysis ◽  
Chinese Studies ◽  
The Difference ◽  
Coagulation Dysfunction ◽  
D Dimer

Abstract Background The aim of this meta-analysis is to assess the prevalence of coagulation dysfunction in Chinese COVID-19 patients and to determine the association of coagulopathy with the severity and prognosis of COVID-19. Methods A meta-analysis of the prevalence of different abnormal coagulation indicators in COVID-19 patients in China was performed. The difference of coagulation indicators and the incidence of DIC were compared between severe cases and nonsevere cases as well as nonsurvivors and survivors, respectively. Results A total of 22 Chinese studies involving 4,889 confirmed COVID-19 inpatients were included. The average D-dimer value of COVID-19 patients is 0.67 µg/mL (95% confidence interval [CI]: 0.56–0.78), and 29.3% (95% CI: 20.1–38.5%) of patients showed elevated D-dimer values. Severe patients had significantly higher D-dimer levels and prolonged prothrombin time (PT) compared with nonsevere patients. Nonsurvivors had significantly higher D-dimer levels, prolonged PT, and decreased platelet count compared with survivors. In total, 6.2% (95% CI: 2.6–9.9%) COVID-19 patients were complicated by disseminated intravascular coagulation (DIC), in which the log risk ratio in nonsurvivors was 3.267 (95% CI: 2.191–4.342, Z = 5.95, p < 0.05) compared with that in survivors. Conclusion The prevalence of coagulopathy in Chinese COVID-19 inpatients is high, and both the abnormal coagulation indicators and DIC are closely associated with the severity and poor prognosis of these COVID-19 patients. Therefore, attention should be paid to coagulation dysfunction in COVID-19 patients. Closely monitoring of coagulation indicators and application of appropriate anticoagulation may improve the prognosis of COVID-19 inpatients in China.

scholarly journals Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 30-30
Author(s):  
Jitender Khunger ◽  
Sahil Diwan ◽  
Santvana Kohli ◽  
Monica Malhotra ◽  
Mohan Agarwal ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Normal Control ◽  
Partial Thromboplastin Time ◽  
Normal Values ◽  
Activated Partial Thromboplastin Time ◽  
Thrombin Time ◽  
Icu Patients ◽  
Coagulation Abnormalities ◽  
D Dimer ◽  
Ap Value

INTRODUCTION COVID-19 started in November 2019 as an infection with a new strain of Corona virus and spread across all geographic regions. It has been observed that various coagulation abnormalities are not infrequent in COVID-19. Bleeding and coagulation abnormalities have surfaced as one of the mechanisms that could be related to increased mortality associated with it. Through our work, we look forward to discovering more on this association & we believe our study could provide new insight that could save additional lives. AIMS & OBJECTIVES - To study coagulation abnormalities in Covid-19 Positive patients. - To correlate these coagulation abnormalities with severity of disease and outcome of Covid-19 Positive patients. Material & Methods:This is a prospective study being carried out on the Intensive Care Unit (ICU) admitted Covid 19 positive patients, in a tertiary care hospital. Fifty cases have been studied so far, to look for coagulation abnormalities. Covid 19 positive patients by RNA detection by RT PCR method, admitted in ICU of hospital have been investigated for Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), Fibrinogen levels and D-Dimer levels.The results of these investigations were correlated with clinical condition of these ICU patients, to assess the prognosisand outcome, of Covid-19 Positive patients. Results: Fifty COVID positive patients admitted in ICU have been studied & out of these 19 patients eventually expired (Non-survivors group) and 31 recovered from their illness (Survivors group). These fifty patients were investigated,at the time of presentation in ICU. Prothrombin time (PT)was prolonged in Covid 19 positive patients. Prothrombin time (PT) values in theSurvivors group ranged from 13.47 to 15.36 seconds(Mean 14.42 seconds). Prothrombin time (PT) values in theNon-survivors group ranged from 13.63 to 15.43 seconds (Mean 14.53 seconds).Normal control of Prothrombin time (PT) was 13 seconds. Prothrombin time (PT) values in the Survivors group were compared with Non-survivors group with ap value = 0.865(statistically not significant). Activated partial thromboplastin time (APTT)values in theSurvivors group ranged from 33.44 to 36.38 seconds(Mean 34.91 seconds). Activated partial thromboplastin time (APTT) values in theNon-survivors group ranged from 33.68 to 38.32 seconds(Mean 36.00 seconds). Normal control of activated partial thromboplastin time (APTT) was 34 seconds. Activated partial thromboplastin time (APTT) values in the Survivors group were compared with Non-survivors group with ap value = 0.397(statistically not significant). Thrombin time (TT)values in theSurvivors group ranged from 17.61 to 19.81 seconds(Mean 18.71 seconds). Thrombin time (TT) values in theNon-survivors group ranged from 18.68 to 22.32 seconds(Mean 20.50 seconds). Normal control of thrombin time (TT) was 18 seconds. Thrombin time (TT) values in the Survivors group were compared with Non-survivors group with ap value = 0.072(statistically not significant). Fibrinogen levelsin theSurvivors group ranged from 378 mgm/dl to 441mgm/dl(Mean 410mgm/dl). Fibrinogen levels in theNon-survivors group ranged from 331 mgm/dl to 419mgm/dl(Mean 375mgm/dl). Normal values for fibrinogen levels were 150 to 450 mgm/dl. Fibrinogen levels in the Survivors group were compared with Non-survivors group with ap value = 0.184(statistically not significant). D-Dimer levelswere increased in Covid 19 positive patients. D-Dimer levels in theSurvivors group ranged from 854 ngm/ml to 1847ngm/ml(Mean 1401ngm/ml). D-Dimer levels in theNon-survivors group ranged from 1308 ngm/ml to 2858 ngm/ml(Mean 2083ngm/ml). Normal values for D-Dimer levels were 135 to 250 ngm/ml. D-Dimer levels in the Survivors group were compared with Non-survivors group with ap value = 0.130(statistically not significant). Conclusion Ours is a small single centre study, however, shows coagulopathies in Covid 19 positive patients. Although, there is a difference between coagulation abnormalities in survivor & non-survivor group of ICU patients but this difference is statistically not significant. Disclosures No relevant conflicts of interest to declare.

scholarly journals The value of D-dimer, ESR and CRP in the Diagnosis of Deep Vein Thrombosis of Lower Limbs After Hip and Knee Joint Replacement

2021 ◽  
Author(s):  
Xinchao Fan ◽  
Kai Zhang ◽  
Xilong Sun ◽  
Xiangrui Duan ◽  
Dadi Wan ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Prothrombin Time ◽  
Knee Replacement ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

Abstract Objective: To investigate the diagnostic value of D-dimer, ESR and CRP in deep vein thrombosis (DVT) of lower extremity after hip and knee replacement.Methods: Clinical data of 216 patients who underwent hip and knee replacement in our hospital from January 2018 to November 2020 were retrospectively analyzed. Among them, there were 86 patients with lower extremity deep vein thrombosis and 130 patients without lower extremity deep vein thrombosis. Preoperative blood D-dimer, prothrombin time, fibrinogen content, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin and hemoglobin levels were collected. Chi-square test was used to compare the rate of deep vein thrombosis in lower limbs. The PSM propensity score matching method was used to select 86 patients from 130 patients without lower extremity deep vein thrombosis (DVT) as control group. The levels of D-dimer, albumin and hemoglobin in 172 patients were compared, and the diagnostic efficacy of D-dimer, ESR and CRP in the diagnosis of lower extremity deep vein thrombosis after hip and knee replacement was analyzed by ROC curve.Results: ROC curve analysis results showed that: The optimal cut-off values of D-dimer, prothrombin time, ESR, CRP and age for the diagnosis of DVT of lower extremity after hip replacement were 1.745mg/L, 10.850s, 15.500mm/h, 2.375mg/L and 72 years old, respectively. The sensitivity was 71.8%, 66.7%, 61.5%, 94.9%, 71.8%, the specificity was 74.1%, 66.7%, 70.4%, 33.3%, 100%, and the area under the curve was 0.746, 0.683, 0.658, 0.651, 0.869. The optimal truncation value of D-dimer for the diagnosis of DVT of lower extremity after knee replacement was 0.285mg/L, the sensitivity was 78.7%, the specificity was 44.1%, and the area under the curve was 0.622.Conclusion: The diagnostic value of D-dimer in the formation of lower extremity DVT after knee arthroplasty is higher than that after hip arthroplasty, but the diagnostic value of prothrombin time, ESR, CRP and age in the formation of lower extremity DVT after hip arthroplasty is higher than that after knee arthroplasty.

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