Novel screening criteria for post-traumatic venous thromboembolism by using D-dimer

Area of Science:

• Trauma and Emergency Medicine
• Hematology
• Diagnostic Imaging

Background:

• Severe trauma patients often develop coagulopathy, increasing the risk of venous thromboembolism (VTE).
• Elevated D-dimer levels post-trauma complicate VTE diagnosis, lacking established reference values.
• Early VTE detection is crucial in acute trauma care.

Purpose of the Study:

• To evaluate novel screening criteria using D-dimer for detecting VTE in severe trauma patients.
• To establish reference values for D-dimer in the context of post-traumatic VTE.
• To improve the efficiency of VTE diagnosis in trauma survivors.

Main Methods:

• A cohort of 455 severe trauma patients was analyzed.
• Screening criteria included: ≥5 days hospital stay, increasing D-dimer over 3 days, and D-dimer ≥15 μg/mL.
• Contrast-enhanced computed tomography (CE-CT) was used to confirm VTE in patients meeting criteria.

Main Results:

• 108 patients met the screening criteria; 73 underwent CE-CT, revealing VTE in 34 (46.6% positive predictive value).
• Median hospital stay was 7 days upon meeting criteria and 10 days before CE-CT.
• No VTE symptoms were observed in diagnosed patients or those not meeting criteria.

Conclusions:

• The developed D-dimer-based screening criteria are effective for identifying VTE in severe trauma patients.
• These criteria provide a valuable reference for efficient VTE detection in this population.
• The findings support the utility of D-dimer monitoring in acute trauma VTE assessment.