Preoperative D-dimer measurement for assessment of venous thromboembolism in colorectal cancer cases.

Abstract

TPS799 Pre-operative D-dimer Measurement for Assessment of Venous Thromboembolism in Colorectal Cancer Cases Background: In Japan, the incidence of venous thromboembolism (VTE) has recently been increasing and gaining attention. Operation or Malignancy is one of the major factors leading to VTE. Thus, there is an urgent need for appropriate pre-operative risk assessment and thorough preventive measures. Caprini score has proven effective and is widely used, however, since the point system is a little cumbersome, there is a strong demand for a risk assessment system that can be more easily used extensively. Methods: This study involving general surgery cases was performed in our department a period of one-half of a year. In order to screen for pre-operative VTE, D-dimer level was measured in 471 general surgical cases (143 colorectal cancer cases, and 99 the other cancer cases, 229 non-cancer cases), and the cases with high D-dimer levels (>1 μg/mL) underwent venous duplex scanning and enhanced computed tomography. Caprini score was measured in all cases for individual VTE risk assessment. By comparing D-dimer levels and Caprini score, the significance of D-dimer testing for VTE screening and risk assessment was reviewed. Results: D-dimer levels were measured in 471 general surgical cases. The 157 cases with high D-dimer levels (>1 μg/mL) underwent venous duplex scanning and enhanced computed tomography. Pre-operative VTE was detected in 16 cases, and the overall prevalence of VTE was 3.4%. For individual VTE risk assessment, Caprini score was derived for all 471cases. Average Caprini score was 5.54 (±1.78) in the high D-dimer group and 4.67 (±1.76) in the low D-dimer group. Using the t-test, Caprini score increased with increasing D-dimer level (P=<0.001). Focused on 143 colorectal cancer cases, 55 with high D-dimer levels and pre-operative VTE detected in 5 cases (3.5%), and Caprini score was 6.51(±1.46) in the high and 5.91(±1.28) in the low (P=0.0141). Conclusion: This observational study suggested that simple D-dimer testing might be worth discussing and considering not only to screen for pre-operative VTE, but also to assess the perioperative VTE risk levels.