This article is more than 5 years old. Information may no longer be current.
Early D-dimer levels may predict chance of DVT development in patients with spinal cord injuries
Click Here to Manage Email Alerts
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.
Click Here to Manage Email Alerts