Abstract
PurposeTo compare the specificity and sensitivity of preoperative D-dimer and age-adjusted D-dimer value for predicting the incidence of the DVT preoperatively in total joint arthroplasty (TJA) patients.MethodsWe enrolled 406 patients finally above 50 years old. Everyone had done ultrasonography bedside, and D-dimer concentrations were collected before surgery. The D-dimer and age-adjusted D-dimer cut-off was calculated by multiple logistic regression and receiver operating curve (ROC) analyses.ResultsA total of 39 patients had found asymptomatic deep vein thrombosis (DVT) by ultrasonography. The age (odds ratio [OR] 1.067; p = 0.003) and D-dimer (OR 1.331; p = 0.025) were related to the existence of DVT. For conventional D-dimer and age-adjusted D-dimer value, the area under the curves (AUCs) were 0.685 (0.499–0.696) and 0.795 (0.611–0.881), respectively.ConclusionCompared to traditional D-dimer, age-adjusted D-dimer showed better performance in screening DVT, which was useful clinically.
Highlights
As is known to all, the total hip arthroplasty (THA) and total knee arthroplasty (TKA) are the effective methods to treat osteoarthritis, but it can bring some complications, such as infection, pain, and deep vein thrombosis (DVT), which was the most common complication
DVT can lead to Pulmonary thromboembolism (PTE), which is the most serious complication after arthrosurgery
The cut-off value of D-dimer is 0.5 μg/ml by latex agglutination turbidimetry (LATEX) in our hospital; in the elderly patients, the Ddimer concentrations are higher than the upper limit of normal age [5]
Summary
As is known to all, the total hip arthroplasty (THA) and total knee arthroplasty (TKA) are the effective methods to treat osteoarthritis, but it can bring some complications, such as infection, pain, and deep vein thrombosis (DVT), which was the most common complication. The incidence of DVT is about 11.9% in THA and 20.8% in TKA after surgery [1]. The prompt diagnosis for thrombosis is the D-dimer test, which can give references to the surgeon [3]. The monitoring value of D-dimer is identified according to different methods. The cut-off value of D-dimer is 0.5 μg/ml by latex agglutination turbidimetry (LATEX) in our hospital; in the elderly patients, the Ddimer concentrations are higher than the upper limit of normal age [5]. The value of D-dimer is discounted in the elderly patients [6]. The pregnancy, Wu et al Journal of Orthopaedic Surgery and Research (2021) 16:82 infection, inflammation, and cancer can lead to high D-dimer value. The only use of D-dimer to predict DVT is not appropriate
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