Changes in LPIA D-dimer levels after total hip or knee arthroplasty relevant to deep-vein thrombosis diagnosed by bilateral ascending venography

Shiota, Naofumi; Satô, Tôru; Nishida, Keiichiro; Matsuo, Masatsugu; Takahara, Yasuhiro; Mitani, Shigeru; Murakami, Takuro; Inoue, Hajime

doi:10.1007/s007760200077

Cited by 49 publications

(41 citation statements)

References 23 publications

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“…However, according to a study of patients who developed DVT after total knee or hip replacement surgery, both the sensitivity and specificity of D-dimer are low, indicating that D-dimer alone does not provide a sufficient means of DVT diagnosis. 8,9 Similar results were obtained in the present study, and the D-dimer level varied depending on the timing of the measurement, indicating a limitation in the accuracy of diagnosis based on D-dimer levels. DVT-inducing pulmonary embolism is a potentially fatal complication, and it seems advisable to use D-dimer only as an auxiliary indicator.…”

Section: Timing and Incidence Of Dvt In Spinal Cord Injury Patientssupporting

confidence: 86%

Prospective study of deep vein thrombosis in patients with spinal cord injury not receiving anticoagulant therapy

et al. 2015

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Study Design: Prospective cross-sectional study. Objectives: To investigate the timing of deep vein thrombosis (DVT) onset secondary to spinal cord injury without anticoagulant therapies. Setting: Spinal Cord Injury Center in Hokkaido, Japan. Methods: Between November 2012 and June 2013, patients with spinal cord injury who were admitted to our hospital within 1 day after the injury and treated surgically within 24 h underwent a neurological examination, leg vein ultrasonography and D-dimer test 1, 3, 7, 14 and 28 days after surgery. All patients received treatment with intermittent pneumatic compression and elastic stockings, but without any anticoagulant. Results: DVT developed in 12 patients (11 men and 1 women), with a mean age of 62.2 years (range, 41-80 years; mean age of total sample, 63.2 years (range, 25-78 years)), all distal to the popliteal vein. DVT occurred more often with a more severe paralysis (66.3%, AIS A and B). The median (± standard error) length of time from the operation to DVT detection was 7.5 ± 2.2 days. The mean D-dimer level upon DVT detection was 14.6 ± 11.8 μg ml − 1 , with no significant differences between those who developed DVT and those who did not at any of the time points. Conclusion: These results suggest that DVT can develop at the very-acute stage of spinal cord injury and the incidence increases with a more severe paralysis. DVT detection was more reliable with ultrasonography, which should be used with DVT-preventive measures, beginning immediately after the injury, for the management of patients with spinal cord injury. INTRODUCTIONDeep vein thrombosis (DVT) is one of the most dangerous complications of a spinal cord injury. DVT has a high incidence in patients with spinal cord injury as compared with patients with other diseases 1 with a high mortality rate if complicated by pulmonary embolism. 2 Although prevention, early detection and timely treatment of DVT are important during the management of patients with spinal cord injury, the timing of DVT onset secondary to a spinal cord injury has not yet been determined. In order to clarify these problems, this study aimed to investigate the timing of DVT onset by prospectively analyzing the patients immediately after a spinal cord injury.

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Section: Timing and Incidence Of Dvt In Spinal Cord Injury Patientssupporting

confidence: 86%

Prospective study of deep vein thrombosis in patients with spinal cord injury not receiving anticoagulant therapy

et al. 2015

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“…A previous study has revealed that a cutoff D-dimer level of 10.0 μg/ml (normal, ≤1.0 μg/ml) on postoperative day 7 shows high specificity in making a diagnosis of DVT after total hip replacement. [5] The mean maximum Ddimer level of 4.1 ± 2.7 μg/ml in the present study was relatively low compared to the previously reported cutoff level for DVT; this may be the reason for symptomatic DVT not developing.…”

Section: Discussioncontrasting

confidence: 73%

“…Although elevated D-dimer levels may not be associated with DVT in this context, further studies may disclose cutoff D-dimer levels for predicting DVT in patients undergoing skin surgery, as a previous orthopedic study revealed in patients undergoing total hip replacement [5].…”

Section: Resultsmentioning

confidence: 78%

“…It often occurs in patients undergoing total hip replacement, and studies have been conducted to elucidate the relationship between DVT and total hip replacement [1][2][3]. The levels of D-dimer, a highly sensitive marker of venous thromboembolism, have been studied among these patients to measure the risk of DVT [4][5][6]. Although patients undergoing lymphadenectomy for metastatic melanomas have been reported to develop DVT [7], the rate of the development of this condition among patients undergoing skin surgery has not been studied.…”

Section: Introductionmentioning

confidence: 99%

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Elevation in D-Dimer Levels after the Surgical Treatment of Stage IA Extramammary Paget’s Disease: A Risk of Deep Vein Thrombosis

2017

ARC Journal of Dermatology

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“…In our hospital, 40.1% of the patients who undergo total hip arthroplasty (THA) develop DVT, which is diagnosed by venography 1) . In the clinical setting, DVT needs to be detected as soon as possible to prevent its progression to pulmonary embolism (PE), which is a life-threatening condition.…”

Section: Introductionmentioning

confidence: 99%

Can Clinical Findings Predict the Complications Associated with Acute-phase Deep Venous Thrombosis after Total Hip Arthroplasty?

et al. 2011

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Abstract.[Purpose] The purpose of this study was to investigate whether clinical findings can be used to predict lower extremity complications associated with deep venous thrombosis (DVT) after total hip arthroplasty (THA). [Subjects and Methods] In all, 37 female patients (mean age, 63.4 ± 10.2 years) with osteoarthritis of the hip who had undergone THA were included in this study. We evaluated pain (Homans sign or tenderness) and edema on the postoperative day when physical therapy was restarted.[Results] Venography revealed that 12 patients had DVT (group D) and 25 patients did not (group N). The intensity of calf pain was significantly higher in group D than in group N. The positive predictive value of pain for DVT was 62.5%, and the negative predictive value of pain was 75.9% (sensitivity, 41.7%; specificity, 88.0%). Patients with proximal DVT tended to have fewer clinical findings than those with distal DVT.[Conclusion] These results suggest that clinical findings are more apparent in patients with DVT; however, proximal DVT would be overlooked because it has few clinical findings.

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Changes in LPIA D-dimer levels after total hip or knee arthroplasty relevant to deep-vein thrombosis diagnosed by bilateral ascending venography

Cited by 49 publications

References 23 publications

Prospective study of deep vein thrombosis in patients with spinal cord injury not receiving anticoagulant therapy

Prospective study of deep vein thrombosis in patients with spinal cord injury not receiving anticoagulant therapy

Elevation in D-Dimer Levels after the Surgical Treatment of Stage IA Extramammary Paget’s Disease: A Risk of Deep Vein Thrombosis

Can Clinical Findings Predict the Complications Associated with Acute-phase Deep Venous Thrombosis after Total Hip Arthroplasty?

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