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 

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

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

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).

scholarly journals Soluble p-selectin, D-dimer, and high-sensitivity C-reactive protein after acute deep vein thrombosis of the lower limb

2011 ◽  
Vol 54 (6) ◽  
pp. 48S-55S ◽  
Author(s):  
Thomas Gremmel ◽  
Cihan Ay ◽  
Daniela Seidinger ◽  
Ingrid Pabinger ◽  
Simon Panzer ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
Acute Deep Vein Thrombosis ◽  
Soluble P ◽  
Deep Vein ◽  
D Dimer

scholarly journals D-dimer is Valuable for Predicting the Extension of Isolated Distal Deep Vein Thrombosis of the Lower Limb in Neurocritical Patients: A Retrospective Observational Study

2021 ◽  
Author(s):  
Rui Tang ◽  
Zhi Gao ◽  
Min Du ◽  
Haiyan Liu ◽  
Yanyan Yang ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Brain Injury ◽  
Lower Limb ◽  
Perioperative Period ◽  
Stroke Patients ◽  
Vein Thrombosis ◽  
Coagulation Function ◽  
Deep Vein ◽  
D Dimer ◽  
Valuable Predictor

Abstract Background: Isolated distal deep vein thrombosis (IDDVT) of the lower limb and its extension to the proximal deep veins have high incidence rates in patients with acute brain injury (ABI). The objective of the study was to determine the value of dynamic changes in coagulation function in predicting the occurrence and extension of IDDVT.Methods: In this retrospective cohort study, ABI patients during the perioperative period in a neurocritical care unit (NICU) of a university hospital were identified from September 2019 to September 2020. Complete compression ultrasound was used by a senior sonographer to diagnose the occurrence and extension of IDDVT. Coagulation function was recorded at a series of time points during the perioperative period.Results: A total of 245 ABI patients were identified, including 46 acute traumatic brain injury patients, 117 acute hemorrhagic stroke patients, 36 acute ischemic stroke patients and 46 acute aneurysmal subarachnoid hemorrhage patients. Most of the patients were elderly and male, and most had severe cases. The rates of IDDVT occurrence and extension were 62% and 21%, respectively. Age, GCS score at admission, NICU length of stay were risk factors for IDDVT occurrence. None of coagulation indices was a sensitive predictor of IDDVT occurrence. The elevation of D-dimer on days 5-7 was the most valuable predictor of IDDVT extension (the area under the ROC was 0.89, with a 95% CI of 0.82-0.95, and the sensitivity and specificity were 0.86 and 0.81, respectively with the cutoff of 8.9 mg/L).Conclusions: The occurrence and extension of IDDVT are common in ABI patients during the perioperative period, particularly in elderly patients with severe cases. D-dimer level on days 5-7 is the most valuable predictor of IDDVT extension in ABI patients.

scholarly journals Prevention of subclinical deep vein thrombosis in abdominal surgeries

2018 ◽  
Vol 5 (7) ◽  
pp. 2475
Author(s):  
Tazeem M. D. ◽  
Wasim M. D. ◽  
Sabia Amin ◽  
Tahmida Ali
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Low Molecular Weight Heparin ◽  
Lower Limbs ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Group I ◽  
Deep Vein ◽  
D Dimer

Background: Deep vein thrombosis (DVT) is a common but elusive illness that can result in disability and death if not recognized and treated effectively. The reported incidence has not changed much over past couple of decades. The aim of this study was to identify the risk of deep vein thrombosis related to the number of days of immobility and the role of low molecular weight heparin in the prevention of deep vein thrombosis.Methods: A total of hundred (n=100) patients undergoing laparotomy were studied in the post-operative period between January 2014 and December 2016. Patients were divided into two groups alternatively; Group I patients did not receive any DVT prophylaxis and Group II patients were given low molecular weight heparin once a day till mobilization. From 3rdPOD, all the patients were evaluated with detailed history and lower limb examination. D-dimer study was done in all the patients and if positive then followed by Color Venous Doppler. Regular follow-ups were done weekly once for a month, every two weeks for next month and once a month thereafter, minimum for 6 months.Results: A total of hundred (n=100) patients, including 65 men and 35 women, with median age of 40 years underwent laparotomies in 2 years by a single unit. The incidence of Lower Limb DVT in Group I was 8%. The risk factors associated with DVT were sex, BMI, smoking and Malignancy. The signs and symptoms associated with DVT were swelling of lower limbs, pain and tenderness, fever and Homan’s and Moses signs. The D-dimer test results were positive in 9 patients. Color Venous Doppler identified DVT in 8 patients. On regular follow- ups, remissions of clinical symptoms were recorded and repeat Doppler scans showed recanalization in all the patients after 6 months.Conclusions: Deep Vein Thrombosis is multifactorial, and post-operative patients account for majority of cases. Early mobilization and Prophylactic Low Molecular Heparin prevents DVT in abdominal surgeries.

Effects of rosuvastatin as an adjuvant treatment for deep vein thrombosis

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Enrique María San Norberto ◽  
María Victoria Gastambide ◽  
James Henry Taylor ◽  
Irene García-Saiz ◽  
Carlos Vaquero
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Duplex Ultrasound ◽  
Final Analysis ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Rosuvastatin Group ◽  
Deep Vein ◽  
D Dimer

Abstract. Background: Statins have been reported to help prevent the development and the recurrence of deep vein thrombosis (DVT). We conducted a prospective randomized clinical trial to compare the effects of rosuvastatin plus a low-molecular-weight heparin (LMWH), bemiparin, with conventional LMWH therapy in the treatment of DVT. Patients and methods: In total, 234 patients were randomized into two groups, 116 in the LMWH group and 118 in the statin plus LMWH group. All patients underwent lower limb duplex ultrasound and analytic markers at diagnosis and three months of follow-up. The final analysis included 230 patients. Results: No significant differences were observed in D-dimer levels after three months of follow-up between patients treated with LMWH+rosuvastatin compared to the LMWH group (802.51 + 1062.20 vs. 996.25 + 1843.37, p = 0.897). The group of patients treated with statins displayed lower levels of CRP (4.17 + 4.27 vs. 22.39 + 97.48, p = 0.018) after three months of follow-up. The Villalta scale demonstrated significant differences between groups (3.45 + 6.03 vs. 7.79 + 5.58, p = 0.035). There was a significant decrease in PTS incidence (Villalta score> 5) in the rosuvastatin group (38.3 % vs. 48.5%, p = 0.019). There were no differences in EuroQol score between groups. Conclusions: Adjuvant rosuvastatin treatment in patients diagnosed of DVT improve CRP levels and diminish PTS incidence.

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

scholarly journals Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-infected and HIV-uninfected patients with deep vein thrombosis

2020 ◽  
Author(s):  
Brandon S Jackson ◽  
Julien Nunes Goncalves ◽  
Etheresia Pretorius
Keyword(s):  
Electron Microscopy ◽  
Deep Vein Thrombosis ◽  
Inflammatory Markers ◽  
Ultrastructural Changes ◽  
Hiv Positive ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Inflammatory Changes ◽  
Scanning Electron ◽  
Hiv Negative

Abstract Background Patients infected with the human immunodeficiency virus (HIV) are more prone to systemic inflammation and pathological clotting, and many may develop deep vein thrombosis (DVT) as a result of this dysregulated inflammatory profile. Coagulation tests are not routinely performed unless there is a specific reason. Methods We recruited ten healthy control subjects, 35 HIV negative patients with deep vein thrombosis (HIV negative-DVT), and 13 HIV patients with DVT (HIV positive-DVT) on the primary antiretroviral therapy (ARV) regimen- Emtricitabine, Tenofovir and Efavirenz. Serum inflammatory markers, haematological results, viscoelastic properties (using thromboelastography-TEG) and scanning electron microscopy (SEM) of whole blood (WB) were used to compare the groups. Results DVT patients (HIV positive and HIV negative) have raised inflammatory markers. The HIV positive-DVT group has anaemia in keeping with anaemia of chronic disorders. DVT patients have a hypercoagulable profile on the TEG but no significant difference between HIV negative-DVT and HIV positive-DVT groups. The TEG analysis compared well and supported our ultrastructural results. Scanning electron microscopy of DVT patient’s red blood cells (RBCs) and platelets demonstrates inflammatory changes including abnormal cell shapes, irregular membranes and microparticle formation. All the ultrastructural changes were more prominent in the HIV positive-DVT patients. Conclusions It is well-known that HIV infection is linked to inflammation and inflammation is linked with the presence of a hypercoagulable state. The presence of DVT is also associated with inflammation. Whether HIV is the cause of the DVT is not certain. Although there were trends that HIV infected patients were more hypercoagulable on functional tests (viscoelastic profile) compared to HIV uninfected patients, there were no significant differences between the 2 groups. Morphologically there were inflammatory changes in patients with DVT. These ultrastructural changes, specifically with regard to platelets, appear more pronounced in HIV infected patients which may contribute to increased risk for hypercoagulability and deep vein thrombosis.

scholarly journals Analysis of risk factors for lower limb deep vein thrombosis in patients after Lumbar Fusion Surgery

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Qiang Li ◽  
Zongxue Yu ◽  
Xiao Chen ◽  
Wenli Zhang
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Lumbar Fusion ◽  
Fusion Surgery ◽  
Vein Thrombosis ◽  
Prophylactic Measures ◽  
Deep Vein ◽  
Limb Deep Vein Thrombosis ◽  
D Dimer

Objective: To identify the risk factors of deep vein thrombosis (DVT) of lower limb in patients undergoing lumbar fusion surgeries, to provide a better understanding of DVT and take prophylactic measures. Methods: This study was carried out in our hospital between January 2016 and February 2020, patients undergoing lumbar fusion surgeries were included and divided into DVT group and non-DVT group, and the medical data including basic demographics, clinical characteristics, operative data, and routine biochemical parameters were collected and analyzed. Results: In the current study, 390 cases were included, 48 cases were enrolled in DVT group and 342 in non-DVT group. The incidence of DVT was 12.3%. There were significant differences in age, hyperlipemia, hypertension, occupation type, D-dimer level, hospital stay, and postoperative exercises (p<0.05), but no significant differences in gender, smoking status, drinking status, coronary heart disease, diabetes mellitus, fused segments, and operation time (p>0.05) between the two groups. In multivariate analysis, age>50 years, hypertension, D-dimer>500ug/L were independent risk factors, while postoperative exercises were protective factor for DVT. Conclusion: Those patients undergoing lumbar fusion surgeries should take more prophylactic measures including postoperative exercises if they were elderly, or hypertensive, or have high D-dimer level, in order to decrease the incidence of DVT. doi: https://doi.org/10.12669/pjms.37.1.3041 How to cite this:Li Q, Yu Z, Chen X, Zhang W. Analysis of risk factors for lower limb deep vein thrombosis in patients after Lumbar Fusion Surgery. Pak J Med Sci. 2021;37(1):239-243. doi: https://doi.org/10.12669/pjms.37.1.3041 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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