Can D-Dimer Levels Predict DVT in Cervical Spinal Cord Injury?

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For patients with acute traumatic cervical SCI, D-dimer levels can predict the likelihood of developing DVT.
For patients with acute traumatic cervical SCI, D-dimer levels can predict the likelihood of developing DVT.

HealthDay News -- For patients with acute traumatic cervical spinal cord injury (SCI), D-dimer levels can predict the likelihood of developing deep vein thrombosis (DVT), according to a study published in The Spine Journal.

Muneaki Masuda, MD, from the Japan Labour Health and Welfare Organization Spinal Injuries Center in Iizuka, and colleagues conducted a prospective clinical study to define the epidemiology and incidence of DVT in acute traumatic cervical SCI in a Japanese population. A total of 268 patients with acute traumatic cervical SCI were enrolled; 211 patients remained after excluding early drop-out patients. Neurologic status assessment and blood chemistry were performed every week until one month after injury.

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The researchers identified DVT in 10.4% of patients. All patients who were positive for DVT had severe paralysis classified as C or greater on the American Spinal Injury Association Impairment Scale. Of the clinical and laboratory parameters, only the D-dimer level at two weeks after injury could accurately predict DVT formation, with 16 µg/dL as the optimal threshold of D-dimer for prediction. For detecting DVT, the sensitivity and specificity were 77.3 and 69.2%, respectively.

"D-dimer levels may be used to predict the likelihood of DVT development in patients with acute cervical SCI," the authors wrote. "Such a screening test would be cost-efficient and simple to administer and could then be followed with additional investigations, such as ultrasonography or venography."

Reference

Masuda M, Ueta T, Shiba K, Iwamoto Y. D-dimer screening for deep venous thrombosis in traumatic cervical spinal injuries. Spine J. 2015;15(11):2338-2344. doi:10.1016/j.spinee.2015.06.060.

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