D-dimer screening for deep venous thrombosis in traumatic cervical spinal injuries

Masuda, Muneaki; Ueta, Takayoshi; Shiba, Keiichiro; Iwamoto, Yukihide

doi:10.1016/j.spinee.2015.06.060

Cited by 37 publications

(25 citation statements)

References 24 publications

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“…Masuda et al . found that all DVT‐positive patients with traumatic cervical spinal injuries had severe paralysis classified as C or greater on the ASIA Impairment Scale, and another study suggested that DVT can develop in the very acute stage of SCI and that the incidence increases with more severe paralysis . In contrast to those findings, we did not find any correlation between DVT and ASIA score.…”

Section: Discussioncontrasting

confidence: 99%

Association between small‐intestinal bacterial overgrowth and deep vein thrombosis in patients with spinal cord injuries

Chen

Zhang

Xie

et al. 2017

Journal of Thrombosis and Haemostasis

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To cite this article: Cheng X, Zhang L, Xie N-C, Xu H-L, Lian Y-J. Association between small-intestinal bacterial overgrowth and deep vein thrombosis in patients with spinal cord injuries. J Thromb Haemost 2017; 15: 304-11. Essentials• Gastrointestinal dysfunction and vein thrombosis are complications after spinal cord injuries (SCI).• We assess the deep vein thrombosis (DVT) and small intestinal bacterial overgrowth (SIBO) in SCI.• 76 of the 377 SCI patients were DVT positive (20.2%) and 145 were defined as SIBO positive (38.5%).• This study defines an association between SIBO and DVT in patient with SCI.

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Section: Discussioncontrasting

confidence: 99%

Association between small‐intestinal bacterial overgrowth and deep vein thrombosis in patients with spinal cord injuries

Chen

Zhang

Xie

et al. 2017

Journal of Thrombosis and Haemostasis

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“…Niikura et al 17. showed that the incidence of VTE in Japanese patients with pelvic and/or lower extremity fractures was 19%, whereas Masuda et al 18. showed that the incidence of DVT with cervical spinal cord injury was 10%.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism in major trauma patients: a single‐center retrospective cohort study of the epidemiology and utility of D‐dimer for screening

Yumoto

Naito

Yamakawa

et al. 2017

Acute Medicine & Surgery

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AimVenous thromboembolism (VTE) can be a life‐threatening complication after major trauma. The aim of this study was to investigate the epidemiology of VTE and to assess the usefulness of D‐dimer for screening for VTE in major trauma cases among the Japanese population.MethodsWe examined a single‐center retrospective cohort of severely injured trauma patients who had been admitted to the emergency intensive care unit at Okayama University Hospital (Okayama, Japan) from April 2013 through to March 2016. Venous thromboembolism was confirmed by computed tomography angiography and computed tomography venography, which was determined based on the attending physician monitoring daily D‐dimer levels. Independent risk factors for VTE were determined by multiple logistic regression analysis. D‐dimer levels were evaluated using area under the receiver operating characteristic curve (AUROC) to predict VTE.ResultsThe study cohort consisted of 204 trauma patients (median Injury Severity Score, 20). Of the 204 patients, 65 (32%) developed VTE. The median time from admission to VTE diagnosis was 10 days. In multiple logistic regression analysis, higher Injury Severity Score and the presence of lower extremity fractures were revealed to be a risk factor for VTE. D‐dimer levels at day 10 showed moderate accuracy, of which the AUROC was 0.785 (95% confidence interval, 0.704–0.866; P < 0.001). The cut‐off that maximized the Youden index was 12.45 μg/mL.ConclusionsAt least one of every three major trauma patients had potential development of VTE at a median of 10 days following admission to the intensive care unit. D‐dimer levels on day 10 can be a useful predictor of VTE.

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“…18,19 Three observational studies examined the role of D-dimer as a screening marker for VTE in patients with SCI. [20][21][22] Two studies reported no difference in D-dimer values in SCI patients who developed VTE compared with those without any events in acute 20 or chronic 21 phases after injury. Another study reported that D-dimer can be utilized as a surrogate marker to predict the likelihood of developing DVT in patients with cervical SCI, and concluded that the optimal timing of performing a D-dimer test should be 2 weeks after injury.…”

Section: Risk Factors For Venous Thromboembolismmentioning

confidence: 99%

“…Another study reported that D-dimer can be utilized as a surrogate marker to predict the likelihood of developing DVT in patients with cervical SCI, and concluded that the optimal timing of performing a D-dimer test should be 2 weeks after injury. 22 However, the D-dimer levels were only reported for patients with VTE, were not compared with those without VTE, and the findings were confined to the cervical level only, which has been reported to have the lowest risk of VTE among spinal cord levels. 16 Given that blood coagulation is very frequently activated and activation of fibrinolysis is also commonplace after acute trauma, most patients with SCI may have elevated D-dimer values, which can result in an increase in imaging tests performed and unnecessary treatment of potentially clinically insignificant findings.…”

Section: Risk Factors For Venous Thromboembolismmentioning

confidence: 99%

Thromboprophylaxis in Patients with Acute Spinal Cord Injury: A Narrative Review

Piran

Schulman

2019

Semin Thromb Hemost

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Patients with acute spinal cord injury (SCI) have the highest risk of venous thromboembolism (VTE) among hospitalized patients. The incidence of total deep vein thrombosis ranges from 50 to 100% in untreated patients and pulmonary embolism is the third most common cause of mortality in these patients. The pathophysiology of the increased risk of VTE is explained by venous stasis after injury, endothelial vessel wall injury from surgery, and a hypercoagulable state associated with trauma. The current thromboprophylaxis options are limited, with low-molecular-weight heparin (LMWH) being the current standard of care. LMWH is commonly administered for 3 months, during which period the risk of VTE is especially high. Some uncertainty exists regarding the optimal timing to initiate pharmacological thromboprophylaxis and the best regimen of LMWH prophylaxis. High-quality data are currently lacking in thromboprophylaxis in patients with SCI. Many questions in this area remain to be answered, which are described in this narrative review.

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D-dimer screening for deep venous thrombosis in traumatic cervical spinal injuries

Cited by 37 publications

References 24 publications

Association between small‐intestinal bacterial overgrowth and deep vein thrombosis in patients with spinal cord injuries

Association between small‐intestinal bacterial overgrowth and deep vein thrombosis in patients with spinal cord injuries

Venous thromboembolism in major trauma patients: a single‐center retrospective cohort study of the epidemiology and utility of D‐dimer for screening

Thromboprophylaxis in Patients with Acute Spinal Cord Injury: A Narrative Review

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