D-dimer as a stand-alone test to rule out deep vein thrombosis

Rinde, Fridtjof B.; Fronas, Synne G.; Ghanima, Waleed; Vik, Anders; Hansen, John‐Bjarne; Brækkan, Sigrid Kufaas

doi:10.1016/j.thromres.2020.04.026

Cited by 18 publications

(16 citation statements)

References 36 publications

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“…Plasma D-dimer is a specific marker of hypercoagulation and secondary fibrinolytic activity, therefore, it is widely used for excluding VTE with the threshold as 500 ng/ml since its high prognostic sensitivity [29]. Since plasma D-dimer level increases with age, tumor, surgery, infection and some other disease status, age-adjusted D-dimer cutoff levels were reported to help to rule out PE among cancer patients [30,31].…”

Section: Discussionmentioning

confidence: 99%

Risk factors and potential predictors of pulmonary embolism in cancer patients undergoing thoracic and abdominopelvic surgery: a case control study

Liu

Chen

et al. 2022

Thrombosis J

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Background Postoperative pulmonary embolism (PE) is a severe complication leading to death and poor prognosis. The present study investigated the risk factors and potential predictors of PE in cancer patients undergoing thoracic and abdominopelvic surgery. Methods A retrospective study was conducted on the patients with cancer who underwent thoracic and abdominopelvic surgery in Sichuan Cancer Hospital from December 2016 to January 2022. A total of 189 patients were included, in which 63 patients diagnosed PE after operation were collected as PE group, and 126 patients matched by age, type of cancer and cancer location were enrolled as control group. Conditional logistic regression was conducted to analyze the association between PE and risk factors. Predictive values of key factors were compared by the area under the curve (AUC) in receiver operating characteristic curve (ROC) curve. Results Conditional multivariate logistic regression showed that BMI (odds ratio [OR] 4.065, 95% confidence interval [CI] 1.138–14.527; p = 0.031), intraoperative hypotension time (OR 4.095, 95% CI 1.367–12.266; p = 0.009), same day fluid balance (OR 0.245, 95% CI 0.061–0.684; p = 0.048), and postoperative D-Dimer (OR 1.693, 95% CI 1.098–2.611; p = 0.017) were significantly related to the occurrence of postoperative PE. Postoperative D-Dimer had the maximal AUC value 0.8014 (95% CI: 0.7260–0.8770) for predicting PE, with a cutoff value of 1.505 μg/ml. Conclusions BMI, intraoperative hypotension time, lower same day fluid balance and postoperative D-dimer are independent risk factors associated with PE in cancer patients undergoing thoracic and abdominopelvic surgery. Postoperative D-Dimer seems to be a good indicator to predict postoperative PE for cancer patients.

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Section: Discussionmentioning

confidence: 99%

Risk factors and potential predictors of pulmonary embolism in cancer patients undergoing thoracic and abdominopelvic surgery: a case control study

Liu

Chen

et al. 2022

Thrombosis J

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“…D-dimer is a degradation product of cross-linked fibrin, which reflects the fibrinolysis status of the system. D-dimer level screening is an exclusion test, with the reason that elevated D-dimer level can be seen in various diseases, including DVT as well [11].…”

Section: Introductionmentioning

confidence: 99%

Clinical Study on the Screening of Lower Extremity Deep Venous Thrombosis by D-Dimer Combined with RAPT Score Among Orthopedic Trauma Patients

Zhao

Ali

Sang

2020

IJOO

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Background Among the causes of mortality in patients with lower extremity fracture following surgery, lower extremity deep venous thrombosis (DVT) is a leading one. To lower the morbidity and mortality, early screening and preventive anticoagulation therapy are essential in clinical study. Common screening methods, including risk prediction tools, imaging tests and D-dimer test, had various drawbacks. The study aimed to establish a new method, that is, D-dimer combined with Risk Assessment and Predictor Tool (RAPT) score, for screening the lower extremity DVT among patients with lower extremity fracture and evaluate its clinical value. Materials and MethodsThe RAPT score, plasma D-dimer and lower extremity venous ultrasonography examination reports were collected from Department of Emergency Surgery & Orthopaedic Surgery from July 2019 to December 2019, and the data were analyzed retrospectively. Regarding the lower extremity venous ultrasonography examination report as the "gold standard" to determine whether DVT exists, the sensitivity, specificity and area under the curve (AUC) of RAPT score alone, plasma D-dimer alone and combination of them in screening lower extremity DVT were analyzed and evaluated. Results 197 patients were enrolled in the study. There were significant differences in D-dimer level and RAPT score between DVT group and non-DVT group (P < 0.01). The sensitivity, specificity and AUC of RAPT score and D-dimer in screening lower extremity DVT were 78.12%, 56.44%, 0.723 and 97.71%, 25.74%, 0.803, respectively. The optimal diagnostic value of D-dimer decided by Youden's index was 1.125 μg/ml. The sensitivity and specificity of the method by combining RAPT score with this new D-dimer threshold were 96.88% and 42.57%, respectively, and AUC was 0.812. Conclusion Higher diagnostic accuracy could be achieved by combining RAPT score with new D-dimer threshold. This novel diagnostic method is potential in the clinical diagnosis of DVT among orthopedic trauma patients.

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“…DD is a fibrin-specific degradation product produced by plasmin hydrolysis. An increase in the level of D-dimer indicates that the body is in a hypercoagulable state, which promotes the formation of BMP [ 22 ]. Relevant studies have found that DD is significantly increased in CAP patients requiring hospitalization, and it is related to disease severity and survival rate [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Adenoviral Load for Bronchial Mucus Plugs Formation in Children with Adenovirus Pneumonia

Liu

Xie

et al. 2022

Canadian Respiratory Journal

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Background. The study aimed to explore risk factors for bronchial mucus plugs (BMP) formation in children with adenovirus (AdV) pneumonia. Methods. A retrospective study was conducted on children with AdV pneumonia who underwent bronchoscopy from January 2019 to December 2019. Children were divided into the BMP group and the control group, depending on whether BMP was formed or not. The clinical information and treatment proposals of the two groups of children were counted and analyzed via multiple logistic regression analysis, ROC curve analysis, and correlation analysis. Results. Among 453 patients with AdV pneumonia, 185 (40.84%) were in the BMP group. Among all the cases, there were 188 patients with a single AdV infection, including 64 (34.04%) in the BMP group and 124 (65.96%) in the control group. The incidence of dyspnea, poor spirits, mixed infections, and other symptoms in the BMP group was higher than in the control group. Children in the BMP group had a longer heat range. C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), and AdV load levels were higher in the MBP group. AdV load, Mycoplasma coinfection, DD, heat range, and LDH were independent risk factors for BMP, among which AdV load was the most significant (AUC = 0.819). AdV load was positively correlated with other risk factors, respectively. AdV load and heat range were independent risk factors for BMP patients with a single AdV infection. Conclusion. AdV load might have important clinical value in predicting BMP development in AdV pneumonia.

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D-dimer as a stand-alone test to rule out deep vein thrombosis

Cited by 18 publications

References 36 publications

Risk factors and potential predictors of pulmonary embolism in cancer patients undergoing thoracic and abdominopelvic surgery: a case control study

Risk factors and potential predictors of pulmonary embolism in cancer patients undergoing thoracic and abdominopelvic surgery: a case control study

Clinical Study on the Screening of Lower Extremity Deep Venous Thrombosis by D-Dimer Combined with RAPT Score Among Orthopedic Trauma Patients

Predictive Value of Adenoviral Load for Bronchial Mucus Plugs Formation in Children with Adenovirus Pneumonia

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