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

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

Annals of Vascular Surgery ◽

10.1016/j.avsg.2014.12.022 ◽

2015 ◽

Vol 29 (4) ◽

pp. 675-681 ◽

Cited By ~ 14

Author(s):

Yong Jiang ◽

Jie Li ◽

Yang Liu ◽

Yuan-Cheng Li ◽

Wei-Guo Zhang

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Orthopedic Surgery ◽

Diagnostic Value ◽

Vein Thrombosis ◽

Deep Vein ◽

D Dimer

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Diagnostic Value of the D-Dimer Test in Deep Vein Thrombosis: Improved Results by a New Assay Method and by Using Discriminate Levels

Thrombosis Research ◽

10.1016/s0049-3848(01)00221-3 ◽

2001 ◽

Vol 102 (2) ◽

pp. 125-131 ◽

Cited By ~ 15

Author(s):

David Shitrit ◽

Judith Heyd ◽

David Raveh ◽

Bernard Rudensky

Keyword(s):

Deep Vein Thrombosis ◽

Diagnostic Value ◽

Assay Method ◽

Vein Thrombosis ◽

Deep Vein ◽

D Dimer

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Limited diagnostic value of Wells-score and D-dimer testing in hospitalized dermatologic patients with symptoms of deep vein thrombosis

European Journal of Dermatology ◽

10.1684/ejd.2013.2188 ◽

2013 ◽

Vol 23 (6) ◽

pp. 830-836 ◽

Cited By ~ 1

Author(s):

Holger A. Haenssle ◽

Nadia Ayad ◽

Timo Buhl ◽

Albert Rosenberger ◽

Kai Martin Thoms ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Diagnostic Value ◽

Vein Thrombosis ◽

Wells Score ◽

Deep Vein ◽

D Dimer

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

10.21203/rs.3.rs-171633/v1 ◽

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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Incidence of Deep Vein Thrombosis after Major HipSurgery and Diagnostic Value of D-dimer

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2006.41.1.103 ◽

2006 ◽

Vol 41 (1) ◽

pp. 103 ◽

Cited By ~ 3

Author(s):

Myung Chul Yoo ◽

Yoon Je Cho ◽

Kang Il Kim ◽

Yang Jin Im ◽

Kye Youl Cho ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Diagnostic Value ◽

Vein Thrombosis ◽

Deep Vein ◽

D Dimer

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Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis

Scientific Reports ◽

10.1038/s41598-017-04843-x ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 9

Author(s):

Jürgen H. Prochaska ◽

Bernd Frank ◽

Markus Nagler ◽

Heidrun Lamparter ◽

Gerhard Weißer ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Diagnostic Value ◽

Vein Thrombosis ◽

Age Related ◽

Deep Vein ◽

D Dimer

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

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650288 ◽

1996 ◽

Vol 75 (03) ◽

pp. 412-416 ◽

Cited By ~ 70

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.

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