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Plasma cross-linked fibrin degradation products fraction D in patients undergoing elective abdominal surgery
O Hauch1, L N Jørgensen, T R Kølle
1Department of Surgery 1, Kommunehospitalet, Copenhagen, Denmark.
Insights
The enzyme immunoassay D-dimer test is not effective for screening postoperative thrombosis in patients undergoing major abdominal surgery. D-dimer levels rise significantly after surgery, but do not reliably indicate thrombosis.
Area of Science:
- Biochemistry
- Vascular Surgery
- Hematology
Background:
- Postoperative deep-venous thrombosis (DVT) is a significant risk following major abdominal surgery.
- Early detection of DVT is crucial for effective patient management and prevention of complications.
- Plasma D-dimer levels are often evaluated as a biomarker for thrombotic events.
Purpose of the Study:
- To evaluate the utility of the enzyme immunoassay (EIA) D-dimer test in screening for postoperative deep-venous thrombosis.
- To assess the dynamic changes in plasma D-dimer concentrations in patients undergoing major abdominal surgery.
Main Methods:
- Plasma D-dimer concentrations were measured in 18 patients undergoing major abdominal surgery using an EIA D-dimer kit.
- Measurements were taken preoperatively, immediately postoperatively, and on postoperative days 1, 3, 4, 5, and 6.
- Patients received low-molecular weight heparin for thromboembolic prophylaxis and were screened with the 125I-fibrinogen uptake test.
Main Results:
- Plasma D-dimer levels significantly increased from a median of 500 ng/ml preoperatively to 1800 ng/ml immediately postoperatively (p < 0.05).
- D-dimer levels continued to rise, reaching a maximum of 4800 ng/ml on postoperative day 6 (p < 0.01).
- One patient developed DVT, and their D-dimer levels were within the range observed in patients without DVT.
Conclusions:
- The EIA D-dimer test is not a reliable screening tool for detecting postoperative thrombosis in this patient cohort.
- Elevated D-dimer levels post-surgery are common and do not specifically correlate with the presence of DVT.
- Further research may be needed to identify more specific biomarkers for postoperative thrombosis.
Abstract:
In 18 patients undergoing major abdominal surgery we measured the plasma D-dimer concentration (EIA d-dimer kit) preoperatively, postoperatively, and on postoperative day 1, 3, 4, 5, and 6. The patients received thromboembolic prophylaxis with low-molecular weight heparin. All patients were screened with the 125I-fibrinogen uptake test. Preoperatively, the median plasma D-dimer concentration was 500 ng/ml (200-3200 ng/ml) rising to 1800 ng/ml (500-4600 ng/ml) (p less than 0.05) immediately postoperatively. The plasma D-dimer level increased further during the following days to a maximum of 4800 ng/ml (1600-8600 ng/ml) on the 6th postoperative day (p less than 0.01). One patient developed deep-venous thrombosis. The plasma D-dimer concentration of this patients was within the range of the other patients. In conclusion, the EIA D-dimer test does not seem to be a potential screening procedure for postoperative thrombosis.