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Title

The value of D-dimer in the detection of early deep-vein thrombosis after total knee arthroplasty in Asian patients: a cohort study.

Authors

Chung-Jen Chen; Ching-Jen Wang; Chung-Cheng Huang

Abstract

Background and purpose: The relationship of D-dimer and deep-vein thrombosis (DVT) after total knee arthroplasty (TKA) remains controversial. The purpose of this study was to assess the value of D-dimer in the detection of early DVT after TKA. Methods: The measurements of plasma D-dimer level were obtained preoperatively and at day 7 postoperatively in 78 patients undergoing TKA. Ascending venography was performed in 7 to 10 days after surgery. The plasma D-dimer levels were correlated statistically with the venographic DVT. Results: Venographic DVT was identified in 40% of patients. High plasma D-dimer level >2.0 µg/ ml was found in 68% of patients with DVT and 45% without DVT (P < 0.05). Therefore, high Ddimer level greater than 2.0 µg/ml showed 68% sensitivity, 55% specificity, 60% accuracy, 50% positive predictive rate and 72% negative predictive rate in the detection of early DVT after TKA. Conclusion: High plasma D-dimer level is a moderately sensitive, but less specific marker in the detection of early of DVT after TKA. Measurement of serum D-dimer alone is not accurate enough to detect DVT after TKA. Venography is recommended in patients with elevated D-dimer and clinically suspected but asymptomatic DVT after TKA.

Subjects

VENOUS thrombosis diagnosis; TOTAL knee replacement; VENOGRAPHY; PULMONARY embolism; ULTRASONIC imaging

Publication

Thrombosis Journal, 2008, Vol 6, p1

ISSN

1477-9560

Publication type

Academic Journal

DOI

10.1186/1477-9560-6-5

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