The Diagnostic Efficacy of Age-Adjusted D-Dimer Cutoff Value and Pretest Probability Scores for Deep Venous Thrombosis

Li, Junxun; Zhang, Fan; Liang, Chujia; Ye, Zhuangjian; Chen, Shaoqian; Cheng, Jing

doi:10.1177/1076029619826317

Cited by 12 publications

(10 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some studies showed that the use of age-adjusted D-dimer cut-off in the diagnostic strategy for the specificity and sensitivity of deep vein thrombosis is more valuable over 50 years old [ 7 , 8 ]. Nybo and Hvas argued that the use of an age-adjusted D-dimer in patients above 50 years of age for ruling out DVT seems as safe as using a standard D-dimer cut-off [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty

Qing

Yao

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

Purpose To compare the specificity and sensitivity of preoperative D-dimer and age-adjusted D-dimer value for predicting the incidence of the DVT preoperatively in total joint arthroplasty (TJA) patients. Methods We enrolled 406 patients finally above 50 years old. Everyone had done ultrasonography bedside, and D-dimer concentrations were collected before surgery. The D-dimer and age-adjusted D-dimer cut-off was calculated by multiple logistic regression and receiver operating curve (ROC) analyses. Results A total of 39 patients had found asymptomatic deep vein thrombosis (DVT) by ultrasonography. The age (odds ratio [OR] 1.067; p = 0.003) and D-dimer (OR 1.331; p = 0.025) were related to the existence of DVT. For conventional D-dimer and age-adjusted D-dimer value, the area under the curves (AUCs) were 0.685 (0.499–0.696) and 0.795 (0.611–0.881), respectively. Conclusion Compared to traditional D-dimer, age-adjusted D-dimer showed better performance in screening DVT, which was useful clinically.

show abstract

Section: Introductionmentioning

confidence: 99%

Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty

Qing

Yao

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…Each variables is strongly associated with DVT in trauma patients. It has previously [23] been described that the D-dimer could further improve both the speci city and the positive predictive value based on age-adjusted cutoff values; therefore, it is not surprising that this was incorporated into our predictive model. The risk factor of ISS has been validated as an independent risk factor for DVT diagnosis, and the incidence of DVT signi cantly increases with increasing ISS trauma score [24].…”

Section: Discussionmentioning

confidence: 93%

Development and Prospective Validation of a Novel Risk Score for Predicting the Risk of Lower Extremity Deep Vein Thrombosis Among Trauma Patients

Peng

Wang

Sun

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Trauma patients have an increased risk of deep vein thrombosis (DVT). Early identification of patients with a high risk of DVT after trauma is crucial for thromboembolism prophylaxis. We aimed to develop and prospectively validate a novel risk score based on a nomogram to predict lower extremity DVT among trauma patients.Methods: Clinical data were collected from 281 trauma patients who were admitted to our trauma center within 24 h of admission from September 2016 to January 2019 to develop a novel DVT risk score. The DVT risk estimates were then calculated prospectively based on the score in a new study cohort from February 2019 to July 2020. The technique of least absolute shrinkage and selection operator (LASSO) was used to select variables for the early prediction of DVT in trauma patients. The DVT risk assessment score (DRAS) was constructed by incorporating related features based on the LASSO analysis and nomogram prediction model. Further, the trauma patients were divided into various risk groups according to the DRAS. The incidence of lower extremity DVT was compared between groups and the discrimination of the DRAS was assessed using the area under the curve (AUC). Results: Based on the LASSO method, eight variables (age, injury severity score, body mass index, D-dimer level, fibrin degradation products, prothrombin time, prealbumin level, and hemoglobin level) were included in the DRAS. A total of 166 trauma patients were enrolled in this prospective study. Increased risk of DVT after trauma was related to higher DRAS. The area under the receiver operating characteristic (ROC) curve for the DRAS was 0.890(0.840–0.939) in the validation cohort. Moreover, the discriminatory capacity of the DRAS was superior to that of each variable independently and the Modified Wells score (P<0.05). Conclusions: We developed and prospectively validated the DRAS to predict the risk of lower extremity DVT among trauma patients, which may facilitate early identification of high-risk patients.

show abstract

“…When employing D-dimer, many studies have taken various measures to improve the diagnostic value of D-dimer. 23 , 31 , 32 Ke et al used a respective cut-off value of D-dimer in subgroups and elevated the diagnostic ability of D-dimer in lung cancer patients after surgery. 23 In the present study, we performed a separate ROC analysis in order to determine the cut-off value in subgroups.…”

Section: Discussionmentioning

confidence: 99%

The Impact of D-Dimer on Postoperative Deep Vein Thrombosis in Patients with Thoracolumbar Fracture Caused by High-Energy Injuries

Wang

et al. 2022

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

Objective To investigate the dynamic variation of D-dimer and to evaluate the efficacy and accuracy of D-dimer level in patients with thoracolumbar fractures caused by high-energy injuries. Methods A total of 121 patients with thoracolumbar fractures caused by high-energy injuries were retrospectively identified and included in this study. There were 83 males and 38 females, with an average age of 48.6 ± 11.2 years. All patients were treated with either screw fixation surgery or decompression fixation surgery. The D-dimer levels were measured 1 day before surgery and on the first, third, and fifth days after surgery. The dynamic variation of D-dimer and the effects of risk factors on D-dimer levels were analysed. A receiver operating characteristic (ROC) curve analysis was performed and the appropriate D-dimer cut-off level was determined for deep vein thrombosis (DVT) screening. Results Due to a trough on the third day, D-dimer levels grew in an unsustainable manner following surgery (P < 0.001). Patients with the operation time >120 min (P = 0.009) and those with an American Spinal Injury Association (ASIA) score A-C (P < 0.001) had higher D-dimer levels. The area under the curve of D-dimer was the greatest on the third day. Applying stratified cut-off values did not change the sensitivity, specificity and negative predictive value in the group with an operation time >120 min, and ASIA score A-C group. Conclusions D-dimer levels elevated with fluctuation in patients with thoracolumbar fractures caused by high-energy injuries after surgery. Both operation time and ASIA score had an impact on D-dimer levels. Regarding DVT diagnoses, the diagnostic value of D-dimer was highest on the third day postoperatively, and stratified cut-off values by these two factors did not show better diagnostic efficacy compared with a collective one.

show abstract

The Diagnostic Efficacy of Age-Adjusted D-Dimer Cutoff Value and Pretest Probability Scores for Deep Venous Thrombosis

Cited by 12 publications

References 28 publications

Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty

Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty

Development and Prospective Validation of a Novel Risk Score for Predicting the Risk of Lower Extremity Deep Vein Thrombosis Among Trauma Patients

The Impact of D-Dimer on Postoperative Deep Vein Thrombosis in Patients with Thoracolumbar Fracture Caused by High-Energy Injuries

Contact Info

Product

Resources

About