Diagnostic accuracy of biomarker D-dimer in patients after stroke suspected from venous thromboembolism: A diagnostic meta-analysis

Zhang, Dongdong; Li, Fenfen; Du, Xinyue; Zhang, Xiaoyan; Zhang, Zaihang; Zhao, Wenchuan; Du, Guangsheng

doi:10.1016/j.clinbiochem.2018.09.011

Cited by 22 publications

(14 citation statements)

References 28 publications

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“…The higher the score, the worse the prognosis, which is the same with the result of our study. A study shows that VTE, D-dimer is a beneficial biomarker for diagnosis of VTE in after stroke patients (19).…”

Section: Discussionmentioning

confidence: 99%

Stratification of venous thromboembolism risk in stroke patients by Caprini score

Zhu¹,

Zhang²,

Zhou³

et al. 2020

Ann Palliat Med

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Background: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolus (PE) is a serious complication in hospitalized stroke patients. This study is designed to examine the incidence of VTE and the effectiveness of chemo thromboprophylaxis in this population. Methods: From January 2015 to April 2018, we calculate the Caprini score for every admitted patient to evaluate VTE risk. For analysis Demographic information, Caprini score, national institutes of health stroke scale (NIHSS) score, prothrombin time (PT), thrombin time (TT), D-Dimer and medical co-morbidity are noted. Results: Of 3,824 inpatients during the study period, 21 patients (0.55%) have VTE complications. Among patients (n=148) with a Caprini score between 0 and 2, 1 patient (0.68%) have VTE. VTE (52.38%) most commonly occurred in patients of Caprini score 7-8 group. In patients with VTE (n=21) age, Caprini score, NIHSS score, National Early Warning Score (NEWS) score, PT, TT, D-Dimer are significantly higher than those (n=3,803) without VTE (P<0.05). Conclusions:The Caprini score is highly recommended to assess the risk of venous thrombosis in stroke patients. Early mechanical and chemical prophylaxis are recommended for patients to reduce the incidence of venous thrombosis.

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Section: Discussionmentioning

confidence: 99%

Stratification of venous thromboembolism risk in stroke patients by Caprini score

Zhu¹,

Zhang²,

Zhou³

et al. 2020

Ann Palliat Med

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“…The diagnostic criteria for thrombosis are recommended that patients determined to have a low risk for DVT, the negative D-dimer accurately ruled out UEDVT without the need for CDU or other imaging tests and helped avoid unnecessary anticoagulant treatment( Fig.1) [1,[9][10][11][12]. However, the algorithm fails when low scores are assigned to patients with VT or when tests give falsenormal D-dimer levels [13].…”

Section: Introductionmentioning

confidence: 99%

Assessment of D-dimer for ruling out peripherally inserted central catheter-associated upper extremity venous thrombosis: a diagnostic accuracy study

Liu¹,

He²,

Zeng³

et al. 2020

Preprint

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Background: With the extensive use of peripherally inserted central catheter (PICC), PICC-associated venous thrombosis (VT) has become one of the most important complications in the hospital. To reduce unnecessary Color Doppler Ultrasound (CDU) or imaging tests, D-dimer values are usually used to exclude VT for patients with low VT risk. There is little evidence for the usefulness of the D-dimer level as an independent diagnostic marker for excluding PICC-associated VT.Aims: To examine the effectiveness of D-dimer values to be used as an independent diagnostic marker for excluding PICC-associated Upper Extremity Venous Thrombosis(UEVT).Methods:Records were reviewed for 281 patients who underwent PICC insertion over the two years period in Xiangya Hospital Central South University.The patients were categorized into the UEVT unlikely group (<2 points) and the UEVT likely group (≥2 points) according to the Constans Clinical Decision Score( Constans score) post PICC insertion, before extubation. After the score was determined, the patients underwent a D-dimer test and CDU within 7 days after D-dimer test.Results: Among 281 patients, 180 patients (36%, 95%CI:30.6%-41.8%) had negative D-dimer results, 39 of 180 patients had VT despite having a negative D-dimer result, resulting in a failure rate of 21.7% (95% CI: 16.3–28.3%).The NPV of PICC-associated VT in the cancer group (80.0%,95% CI: 73.2–85.4%) was higher than that of the non-cancer group (60.0%,95% CI: 35.7–80.2%). The NPV of PICC-associated DVT(Deep Venous Thrombosis) (84.9%,95% CI: 78.7–89.6%) was lower than that of the PICC-associated SVT(Superficial Venous Thrombosis) (91.0% ,95% CI: 85.4–94.6%).Conclusion: The D-dimer levels maybe should not be used as a diagnostic index to rule out PICC-associated VT to avoid missed diagnosis of PICC-related VT, which may cause adverse consequences.

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“…[ 8 , 9 ] Meanwhile, D-D, a specific degradation product formed after hydrolysis of cross-linked fibrin protease, is a promising biomarker for the identification of venous thromboembolism in stroke cases. [ 10 ] Another factor implicated in stroke is LP(a), a low density lipoprotein strongly inducing thrombosis. [ 11 ] Despite the available wealth of knowledge regarding the associations of LP(a), Hcy and D-D with stroke in China and other countries, [ 8 – 11 ] few studies have assessed the associations of these factors with stroke subtype.…”

Section: Introductionmentioning

confidence: 99%

Associations of plasma LP(a), Hcy and D-D levels with the subtype of ischemic cerebrovascular disease

Tang

Geng

2019

Medicine

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The relevance of LP(a), Hcy, and D-D in ischemic cerebrovascular disease remains undefined. This study aimed to assess the associations of plasma LP(a), Hcy and D-D levels with the subtype of ischemic cerebrovascular disease.Patients with ischemic cerebrovascular disease admitted to the Taixing People's Hospital were retrospectively enrolled from November 2017 to July 2018. Immunoturbidimetry was used to assess 119 LAA, 107 SAO, and 112 TIA patients for plasma LP(a), Hcy, and D-D levels.Plasma LP(a), Hcy, and D-D levels in the large artery atherosclerosis (LAA) group were significantly lower than those of the transient ischemic attack (TIA) group (all P < .05). LP(a), Hcy, and D-D levels were significantly reduced in the SAO group compared with the TIA group (both P < .05). The LAA and SAO groups showed comparable values for all the above parameters (P > .05).LP(a), Hcy, and D-D levels differ according to the subtype of ischemic cerebrovascular disease.

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Diagnostic accuracy of biomarker D-dimer in patients after stroke suspected from venous thromboembolism: A diagnostic meta-analysis

Cited by 22 publications

References 28 publications

Stratification of venous thromboembolism risk in stroke patients by Caprini score

Stratification of venous thromboembolism risk in stroke patients by Caprini score

Assessment of D-dimer for ruling out peripherally inserted central catheter-associated upper extremity venous thrombosis: a diagnostic accuracy study

Associations of plasma LP(a), Hcy and D-D levels with the subtype of ischemic cerebrovascular disease

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