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Association between elevated D-dimer levels and deep vein thrombosis following neurosurgery
Maria Teresa Sartori1, Alessia Bozzolin2,3, Pietro Ciccarino4
1Clinical Medicine 1, Department of Medicine, University Hospital of Padua, Padua, Italy. mtsart@unipd.it.
Journal of Thrombosis and Thrombolysis
|March 6, 2026
Summary
Elevated D-dimer levels can help diagnose deep vein thrombosis (DVT) in neurosurgery patients post-operation. A D-dimer threshold of 1334 µg/L showed high sensitivity for suspected DVT, aiding early detection.
Area of Science:
- Neurosurgery
- Vascular Medicine
- Diagnostic Imaging
Background:
- Neurosurgical patients face high post-operative thromboembolic risk despite prophylaxis.
- Early diagnosis of deep vein thrombosis (DVT) in this population is challenging.
Purpose of the Study:
- To determine if elevated D-dimer levels can aid in diagnosing post-operative DVT in neurosurgical patients.
- Investigate the association between D-dimer levels and DVT risk after neurosurgery.
Main Methods:
- Retrospective observational study of 556 neurosurgical patients.
- Venous ultrasound (US) assessment for suspected DVT prompted by elevated D-dimer levels.
- Logistic regression and ROC curve analysis to identify D-dimer cut-offs and assess DVT risk.
Main Results:
- Among 73 patients with elevated D-dimer, 35 had venous thrombosis, including 20 DVTs.
- D-dimer levels were significantly higher in patients with DVT (OR 1.98 per 1000 µg/L increase).
- Optimal D-dimer cut-off of 1334 µg/L (sensitivity 0.90) and a threshold of 2200 µg/L (PPV 77%) were identified.
Conclusions:
- Elevated D-dimer levels are associated with an increased risk of DVT after neurosurgery.
- D-dimer testing, particularly with specific thresholds, can assist in the diagnosis of post-operative DVT in neurosurgical patients.
- Further investigation into D-dimer's role in thromboprophylaxis management is warranted.
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