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Perioperative d-dimer levels in patients with musculoskeletal tumors
Takeshi Morii1, Kazuo Mochizuki, Masazumi Kotera
1Department of Orthopaedic Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka, Tokyo 181-8611, Japan.
Background:
D-dimer (DD) levels have been reported as a sensitive but non-specific indicator for deep vein thrombosis (DVT) and pulmonary embolism (PE). Few reports have examined perioperative DD levels in musculoskeletal tumor.
Materials/Methods:
Subjects comprised 77 patients who had undergone oncological resection of musculoskeletal tumor. DD levels were assessed preoperatively and on postoperative days 1 and 7. Multidetector-row computed tomography (MD-CT) was performed to detect DVT/PE for cases with DD level >10.0 microg/ml.
Results:
Mean preoperative DD level was 0.84 microg/ml. Significant elevation of postoperative DD levels was confirmed. DD levels were significantly changed by various clinical conditions, such as malignancy, age and prosthetic reconstruction. In 4 of 5 cases with postoperative DD levels >10.0 microg/ml, DVT/PE was detected.
Conclusion:
Activation of the coagulation system by surgery and heterogeneity of DD levels under various clinical conditions in musculoskeletal tumor patients were suggested.
Insights
Postoperative D-dimer (DD) levels increase significantly after musculoskeletal tumor surgery. Elevated DD levels may indicate deep vein thrombosis (DVT) or pulmonary embolism (PE), influenced by factors like malignancy and age.
Area of Science:
- Oncology
- Hematology
- Radiology
Background:
- D-dimer (DD) is a sensitive but non-specific marker for deep vein thrombosis (DVT) and pulmonary embolism (PE).
- Limited data exists on perioperative D-dimer levels in musculoskeletal tumor patients.
Purpose of the Study:
- To investigate perioperative D-dimer levels in patients undergoing musculoskeletal tumor resection.
- To assess the correlation between D-dimer levels and the incidence of DVT/PE in this patient cohort.
Main Methods:
- 77 patients undergoing oncological resection of musculoskeletal tumors were studied.
- D-dimer levels were measured preoperatively and on postoperative days 1 and 7.
- Multidetector-row computed tomography (MD-CT) was used to diagnose DVT/PE for elevated D-dimer levels (>10.0 microg/ml).
Main Results:
- Mean preoperative D-dimer level was 0.84 microg/ml.
- Postoperative D-dimer levels showed significant elevation.
- D-dimer levels were influenced by malignancy, age, and prosthetic reconstruction.
- DVT/PE was detected in 4 out of 5 cases with postoperative D-dimer levels >10.0 microg/ml.
Conclusions:
- Musculoskeletal tumor surgery activates the coagulation system, leading to elevated D-dimer levels.
- D-dimer levels exhibit heterogeneity in these patients due to various clinical factors.
- Perioperative D-dimer monitoring may aid in identifying DVT/PE risk in musculoskeletal tumor patients.