PPREOPERATIVE D-DIMER AND DEEP VEIN THROMBOSIS IN PATIENTS SCHEDULED FOR ORTHOPEDIC SURGERY
Tomoki Nishiyama* MD, PhD
ABSTRACT
Background: The present study was performed to obtain cut-off value of D-dimer for negative DVT in patients
scheduled for spine, joint, or fracture surgery retrospectively. Methods: Data of the patients who received spine
(1820 cases), fracture (246 cases), and joint (516 cases) surgeries in these 5 years were extracted. In patients with
D-dimer ≧ 2.0 μg/mL, echography was performed to detect thrombosis in heart, neck, and lower extremities.
Patients were divided into three subgroups with no thrombus, new thrombus, or old thrombus by echography. Cutoff
value was calculated using receiver operatorating characteristic curve. Results: In spine surgery, D-dimer was
significantly higher in the order of new thrombus > old thrombus > no thrombus. Using the cut-off values obtained
in this study, 6 cases with new thrombus and 25 cases with old thrombus in spine surgery, 19 cases with new
thrombus and 36 cases with old thrombus in fracture surgery, and 4 cases with new thrombus and 2 cases with old
thrombus in joint surgery were false negatives. The minimum D-dimer with thrombus was 2.0 μg/mL, 2.1 μg/mL,
and 2.0 μg/mL, in spine, fracture, and joint surgery, respectively. Conclusions: Echography should be performed
to detect DVT when preoperative D-dimer is ≧ 2.0 μg/mL in spine surgery, ≧ 2.1 μg/mL in fracture surgery and ≧
2.0 μg/mL in joint surgery.
Keywords: D-dimer, Deep vein thrombosis, Spine surgery, Fracture surgery, Joint replacement surgery.
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