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

Wu, Jian; Qing, Jiang Hui; Yao, Yao; Chen, Dong Yang; Jiang, Qing

doi:10.1186/s13018-020-02172-w

Cited by 22 publications

(19 citation statements)

References 18 publications

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“…In our study, the incidence rate of asymptomatic DVT was 12.89%(33/256). In the study by Vincent et al, the incidence of DVT was 12.8% after THA/TKA [ 21 ], similar to a study by Wu et al; the rate was 9.6% [ 9 ]. These findings are consistent with our research.…”

Section: Discussionsupporting

confidence: 53%

“…Despite the relatively low incidence of DVT, this result is because ultrasound was not routinely performed, only for symptomatic patients following major orthopedic surgery before hospital discharge [ 4 ]. In a routine ultrasound screening study, 26 patients (47%) had asymptomatic distal DVT after TKA [ 8 ], and 39 patients (9.6%) had asymptomatic DVT after THA [ 9 ]. Thus, asymptomatic DVT also needs to be identified early to avoid the development of PE.…”

Section: Introductionmentioning

confidence: 99%

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Thrombin antithrombin complex concentration as an early predictor of deep vein thrombosis after total hip arthroplasty and total knee arthroplasty

Lin

Sun

Deng

et al. 2022

BMC Musculoskelet Disord

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Aim Early predictive markers of venous thromboembolism (VTE) after total hip arthroplasty (THA)/total knee arthroplasty (TKA) remain unclear. Our study identified early predictive markers for VTE after THA/TKA. Methods A single-institution retrospective review study was conducted between May 2020 and April 2022 (n = 256). All patients underwent Doppler ultrasounds exam in preoperation and seventh day after surgery. Deep vein thrombosis (DVT) was defined by Doppler ultrasound of the lower extremities, which revealed thrombosis. Thrombin-antithrombin complex (TAT), thrombomodulin (TM), and plasmin-antiplasmin complex (PIC) concentration were tested from each patient’s preoperative and postoperative days 1, 4, 7, 14. These values were then accessed via receiver operating characteristic (ROC) curve analysis and further quantified the level of this risk by concentration. Results On postoperative day 1 (pod-1), all patients’ TAT and PIC concentrations were significantly higher than those preoperatively (p < 0.05). The levels of TAT and PIC in patients in the DVT group on pod-1 were significantly higher than those in the non-DVT group (p < 0.05). At pod-1, the TAT concentration for DVT patients was 49.47 ng/mL compared to 20.70 ng/mL for non-DVT patients, PIC was 3.72μg/mL compared to 1.65μg/mL. ROC curve analysis demonstrated that a TAT concentration of 24.3 ng/mL had a sensitivity of 87.9% and a specificity of 69.1%. Conclusion TAT levels on pod-1 may predict DVT early after THA/TKA, which makes it possible for early intervention to decrease the incidence of DVT.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Thrombin antithrombin complex concentration as an early predictor of deep vein thrombosis after total hip arthroplasty and total knee arthroplasty

Lin

Sun

Deng

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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“…In such cases, further testing is unnecessary even in patients with a previous DVT [ 25 ]. Many studies on DVT in patients with lower limb fractures have now shown that preoperative D-dimer is an independent risk factor for DVT [ 26 , 27 , 28 ]. We confirm this point in our analysis in this study.…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors for New-Onset Calf Muscle Venous Thrombosis after Hip Fracture Surgery

Zhuang

Aikebaier

et al. 2023

JPM

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Background: Calf muscle venous thrombosis (CMVT) is among the most important medical complications after hip surgery. CMVT has been known for many years, but many opinions about the incidence and risk factors of CMVT are still controversial. The objective of this retrospective study was to investigate the incidence and associated risk factors of postoperative CMVT in patients with hip fractures. Methods: Patients with hip fractures from January 2020 to April 2022 (n = 320) at Shenzhen Second People’s Hospital were recruited in this study. The personal characteristics and clinical data of CMVT and no-CMVT patients were compared and analyzed. Binary logistic regression analyses were performed to identify potential risk factors of CMVT in patients with hip fractures. Finally we performed a receiver operating characteristic (ROC) curve analysis to compare the diagnostic values of different variables. Results: The overall incidence of new-onset CMVT in patients with hip fractures was 18.75% (60 of 320). Among the 60 CMVT patients, 70% (42 of 60) were diagnosed with femoral neck fractures, 28.3% (17 of 60) with intertrochanteric fractures, and 1.7% (1 of 60) with subtrochanteric fractures. No pulmonary embolism (PE) occurred. High preoperative D-dimer (OR = 1.002, 95%CI 0.97–1.03), sex (OR = 1.22, 95%CI 0.51–2.96), the caprini score (OR = 2.32, 95%CI 1.05–5.16) and the waterlow score (OR = 1.077, 95%CI 0.35–3.36) significantly increased the risk of developing postoperative new-onset CMVT. Conclusions: CMVT has become a common clinical disease, and its harm should not be underestimated. Our study found that D-dimer, sex, the caprini score and the waterlow score were independent risk factors for postoperative CMVT. According to our clinical work, we should pay attention to identifying the risk factors of CMVT formation and targeted intervention measures to prevent new-onset CMVT.

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“…So, in elderly patients, the D-dimer level should be adjusted by age. Currently, many studies have already reported the age-adjusted D-dimer cutoff values in elderly patients ( 43 – 45 ). However, there has been no such a concrete and unified calculation formula about the age-adjusted D-dimer.…”

Section: Discussionmentioning

confidence: 99%

Exploration of prognostic factors for prediction of mortality in elderly CAP population using a nomogram model

Shi

et al. 2022

Front. Med.

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BackgroundThe incidence and mortality rate of community-acquired pneumonia (CAP) in elderly patients were higher than the younger population. The assessment tools including CURB-65 and qSOFA have been applied in early detection of high-risk patients with CAP. However, several disadvantages exist to limit the efficiency of these tools for accurate assessment in elderly CAP. Therefore, we aimed to explore a more comprehensive tool to predict mortality in elderly CAP population by establishing a nomogram model.MethodsWe retrospectively analyzed elderly patients with CAP in Minhang Hospital, Fudan University. The least absolute shrinkage and selection operator (LASSO) logistic regression combined with multivariate analyses were used to select independent predictive factors and established nomogram models via R software. Calibration plots, decision curve analysis (DCA) and receiver operating characteristic curve (ROC) were generated to assess predictive performance.ResultsLASSO and multiple logistic regression analyses showed the age, pulse, NLR, albumin, BUN, and D-dimer were independent risk predictors. A nomogram model (NB-DAPA model) was established for predicting mortality of CAP in elderly patients. In both training and validation set, the area under the curve (AUC) of the NB-DAPA model showed superiority than CURB-65 and qSOFA. Meanwhile, DCA revealed that the predictive model had significant net benefits for most threshold probabilities.ConclusionOur established NB-DAPA nomogram model is a simple and accurate tool for predicting in-hospital mortality of CAP, adapted for patients aged 65 years and above. The predictive performance of the NB-DAPA model was better than PSI, CURB-65 and qSOFA.

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

Cited by 22 publications

References 18 publications

Thrombin antithrombin complex concentration as an early predictor of deep vein thrombosis after total hip arthroplasty and total knee arthroplasty

Thrombin antithrombin complex concentration as an early predictor of deep vein thrombosis after total hip arthroplasty and total knee arthroplasty

The Risk Factors for New-Onset Calf Muscle Venous Thrombosis after Hip Fracture Surgery

Exploration of prognostic factors for prediction of mortality in elderly CAP population using a nomogram model

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