Diagnostic Value of Elevated D-Dimer Level in Venous Thromboembolism in Patients With Acute or Subacute Brain Lesions
Annals of Rehabilitation Medicine
;
: 1002-1010, 2015.
Article
in English
| WPRIM
| ID: wpr-96150
ABSTRACT
OBJECTIVE:
To define the risk factors that influence the occurrence of venous thromboembolism (VTE) in patients with acute or subacute brain lesions and to determine the usefulness of D-dimer levels for VTE screening of these patients.METHODS:
Medical data from January 2012 to December 2013 were retrospectively reviewed. Mean D-dimer levels in those with VTE versus those without VTE were compared. Factors associated with VTE were analyzed and the odds ratios (ORs) were calculated. The D-dimer cutoff value for patients with hemiplegia was defined using a receiver operating characteristic (ROC) curve.RESULTS:
Of 117 patients with acute or subacute brain lesions, 65 patients with elevated D-dimer levels (mean, 5.1+/-5.8 mg/L; positive result >0.55 mg/L) were identified. Logistic regression analysis showed that the risk of VTE was 3.9 times higher in those with urinary tract infections (UTIs) (p=0.0255). The risk of VTE was 4.5 times higher in those who had recently undergone surgery (p=0.0151). Analysis of the ROC showed 3.95 mg/L to be the appropriate D-dimer cutoff value for screening for VTE (area under the curve [AUC], 0.63; 95% confidence interval [CI], 0.5-0.8) in patients with acute or subacute brain lesions. This differs greatly from the conventional D-dimer cutoff value of 0.55 mg/L. D-dimer levels less than 3.95 mg/L in the absence of surgery showed a negative predictive value of 95.8% (95% CI, 78.8-99.8).CONCLUSION:
Elevated D-dimer levels alone have some value in VTE diagnosis. However, the concomitant presence of UTI or a history of recent surgery significantly increased the risk of VTE in patients with acute or subacute brain lesions. Therefore, a different D-dimer cutoff value should be applied in these cases.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pulmonary Embolism
/
Urinary Tract Infections
/
Brain
/
Brain Diseases
/
Logistic Models
/
Odds Ratio
/
Mass Screening
/
Retrospective Studies
/
Risk Factors
/
ROC Curve
Type of study:
Diagnostic study
/
Etiology study
/
Observational study
/
Prognostic study
/
Screening study
Limits:
Humans
Language:
English
Journal:
Annals of Rehabilitation Medicine
Year:
2015
Type:
Article
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