Cutoff values of plasma d-dimer level in patients with diagnosis of the venous thromboembolism after elective spinal surgery.
Cutoff values of plasma d-dimer level in patients with diagnosis of the venous thromboembolism after elective spinal surgery.
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DOI：
10.4184/asj.2015.9.2.232
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发表时间：
2015-04
影响因子：
2.3
通讯作者：
Riazi M
中科院分区：
文献类型：
--
作者：
Hamidi S;Riazi M
一项前瞻性临床研究。我们在这项研究中的目标有两个。首先，我们试图评估术后静脉血栓栓塞症(VTE)的发展与D-二聚体浓度的关系，以确定择期脊柱手术患者的临界值。其次，我们确定了术后静脉血栓栓塞术的预测危险因素。静脉血栓栓塞会影响患者的一般健康，甚至可能导致死亡。由于VTE的并发症难以预测，因此应使用最安全和最经济的诊断方法来确定脊柱手术后可疑的VTE事件。这项研究是对97名接受择期脊柱手术的患者进行的。D-二聚体测定在手术前一天、手术后第1、3、10天进行。比较两组VTE发生率和D-二聚体水平。4名患者(4.1%)被诊断为深静脉血栓形成，1名患者(1%)被诊断为肺栓塞。静脉血栓栓塞组D-二聚体在术后第3天的最佳界值为>2.1µg/mL，其敏感性为100%，特异性为80.7%。此外，在本研究中，术后卧位时间是发生静脉血栓栓塞症的重要危险因素。我们已经证明，在接受择期脊柱手术的患者中，术后D-二聚体的测定可以在术后第一周内为VTE提供补充的诊断筛查。
A prospective clinical study. Our objective in the present study was twofold. First, we sought to evaluate the relationship between postoperative venous thromboembolism (VTE) development and concentration of D-dimer to determine the cutoff value in patients who underwent elective spinal surgery. Second, we identified the predictive risk factors for postoperative VTE. VTE affects the general health of patients and may even cause death. Since the complications of VTE are difficult to predict, the safest and most cost effective diagnostic method should be used in order to confirm a suspected VTE event after spinal surgery. This study was performed on 97 patients who underwent elective spinal surgery. The D-dimer assay was carried out on the day before surgery, and on days 1, 3, and 10 following surgery. VTE occurrence and D-dimer levels were compared between the VTE and the control groups. Four patients (4.1%) were diagnosed with deep vein thrombosis and one patient (1%) was diagnosed with a pulmonary embolism. The optimum D-dimer cutoff value on day 3 following surgery in the VTE group was determined to be more than 2.1 µg/mL with a sensitivity of 100% and a specificity of 80.7%. Moreover, the duration of postoperative recumbency was a significant risk factor for the development of VTE in this study. We have demonstrated that postoperative D-dimer measurements in patients who underwent elective spinal surgery can provide a complementary diagnostic screening for VTE during the first week after surgery.