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Published on: June 2, 2015
D-Dimer Variability Predicts Venous Thromboembolism in Postoperative Fracture Patients: A Single-Center Retrospective
Xin-Miao Chen1, Hui Huang1, Fen-Hua Jin1
1Department of Respiratory Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Summary
D-dimer variability, the ratio of postoperative to preoperative levels, is a more accurate predictor of venous thromboembolism (VTE) in fracture patients than D-dimer alone. A variability of 2.0 or higher identifies patients at increased VTE risk.
Area of Science:
- Orthopedics
- Vascular Surgery
- Diagnostic Biomarkers
Background:
- Venous thromboembolism (VTE) is a serious complication after traumatic fractures.
- Plasma D-dimer is a common but often non-specific biomarker for VTE.
- The diagnostic utility of D-dimer variability for VTE prediction in this population is underexplored.
Purpose of the Study:
- To assess if D-dimer variability is a superior predictor of postoperative VTE compared to D-dimer levels alone.
- To identify specific patient subgroups who may benefit most from VTE risk assessment using D-dimer variability.
Main Methods:
- Retrospective analysis of 77,609 traumatic fracture patients.
- D-dimer variability calculated as the ratio of postoperative to preoperative D-dimer levels.
- VTE diagnosis confirmed via duplex ultrasonography and CT pulmonary angiography.
Main Results:
- Postoperative D-dimer variability was significantly higher in patients with VTE (2.30) versus those without (1.33).
- A D-dimer variability cutoff of 2.0 demonstrated 83.44% sensitivity and 88.60% specificity for VTE.
- Independent VTE risk factors included age > 60, female sex, and lower extremity fractures.
Conclusions:
- D-dimer variability is a strong predictor of VTE in postoperative traumatic fracture patients.
- A D-dimer variability threshold of 2.0 can identify high-risk individuals for VTE.
- This biomarker is particularly valuable for VTE risk stratification in elderly, female, and lower extremity fracture patients.
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