Document Detail


Prediction of deep vein thrombosis after total knee arthroplasty with preoperative D-dimer plasma measurement.
MedLine Citation:
PMID:  20128069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite prophylaxis, deep vein thrombosis (DVT) still occurs frequently after elective knee surgery. Hence, it would be helpful if the high-risk DVT patients could be identified before surgery so the adequate prophylaxis could be given. A normal plasma D-dimer level effectively rules out acute DVT patients who were classified as having low clinical probability. In many studies, one coagulation activation marker was measured to observe their role in preoperative prediction ofDVT after major hip or knee surgery. In this study, the preoperative plasma level of D-dimer in patients undergoing total knee arthroplasty (TKA) was collected, and correlated with the results of postoperative venography OBJECTIVE: To determine whether levels of D-dimer in plasma, taken two weeks preoperatively, predicts the development of DVT in patients undergoing TKA. MATERIAL AND METHOD: Fifty-nine consecutive patients undergoing TKA were seen in a preoperative clinic two weeks prior the surgery and had blood taken for measurement of plasma D-dimer. After surgery, they did not receive prophylaxis anticoagulant. Ascending contrast venography of both lower extremities was performed in all cases between the 6th-l0th postoperative day or earlier if clinical symptoms occurred. RESULTS: Plasma D-dimer was measured preoperatively in 59 patients undergoing TKA. DVT was detected by venography in 31 (53%) patients. At a cutoff or 500 ng/ml, the sensitivity, specificity, positive and negative predictive values of the preoperative D-dimer concentration for the development of subsequent DVT were 58%, 46%, 55%, and 50%, respectively. CONCLUSION: The results of the present study suggested that preoperative plasma measurement of D-dimer concentration is not useful for predicting DVT in patients undergoing TKA.
Authors:
Thanainit Chotanaphuthi; Danai Heebthamai; Worasun Taweewuthisub; Satit Thiengwittayaporn; Suwat Roschan; Kris Kanchanaroek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  92 Suppl 6     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  S6-10     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. tanainit@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Antifibrinolytic Agents / metabolism
Arthroplasty, Replacement, Knee / adverse effects*,  methods
Female
Fibrin Fibrinogen Degradation Products / analysis*
Humans
Male
Middle Aged
Phlebography
Postoperative Complications / blood*,  etiology,  prevention & control,  radiography
Postoperative Period
Predictive Value of Tests
Preoperative Care
Risk Factors
Sensitivity and Specificity
Venous Thrombosis / blood*,  etiology,  radiography
Chemical
Reg. No./Substance:
0/Antifibrinolytic Agents; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

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