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Early D-dimer levels may predict chance of DVT development in patients with spinal cord injuries
Data from this recently published prospective, clinical study showed serum D-dimer levels in patients with acute traumatic cervical spinal cord injuries may be used to predict the likelihood of deep vein thrombosis development, with levels at 2 weeks post-injury showing the greatest accuracy.
Researchers included 211 patients with acute traumatic cervical spinal cord injuries who were admitted to the researchers’ facility within 2 weeks of their injury. Investigators assessed patients’ blood chemistry and neurological status every week for 1 month after injury. Every 2 weeks, investigators used ultrasound to detect deep vein thrombosis (DVT). DVT was detected in 22 patients (10.4%), and all DVT-positive patients received anticoagulant therapy with intravenous heparin and oral warfarin.
At admission, DVT patients exhibited an average D-dimer value of 10 μg/dL, which significantly increased to 31 μg/dL at 2 weeks after admission. Non-DVT patients exhibited average D-dimer values of 14.1 μg/dL at the time of admission, which increased to 15 μg/dL at 2 weeks.
Researchers conducted a multivariate logistic analysis of clinical and laboratory parameters and found only the D-dimer levels at 2 weeks after an injury were accurate predictors of DVT formation. Use of D-dimer levels at more than 16 μg/dL for detecting DVT showed a specificity of 69.3% and a sensitivity of 77.3%.
“In the present study, we determined that the optimal cutoff point of D-dimer was 16 μg/dL because of a good balance among sensitivity, specificity, and odds ratio. The results from this prospective study indicate that if the value of D-dimer at 2 weeks after injury rises more than 16 μg/dL, additional investigation through color Doppler [ultrasound] US or venography should be considered,” researchers wrote in the study. – by Robert Linnehan.
Disclosure: Musada reports receiving grants from The General Insurance Association of Japan, The Japan Labour Health and Welfare Organization and The Japan Orthopedics and Traumatology Foundation.