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Correlation of Preoperative d-dimer Levels and Postoperative Venous Thromboembolism in Patients Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty

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Open Journal of Orthopedics 2021年第9期11卷 269-277页

作者： Sanjay Agarwala Mayank Vijayvargiya Neeraj Mishra department of Orthopedics P.D. Hinduja National Hospital Mumbai India

Background: The relationship of preoperative d-dimer and Venous thromboembolism (VTE) after total knee arthroplasty (TKA) and total hip arthroplasty (THA) remains controversial. The purpose of this study was to assess... 详细信息

Background: The relationship of preoperative D-dimer and Venous thromboembolism (VTE) after total knee arthroplasty (TKA) and total hip arthroplasty (THA) remains controversial. The purpose of this study was to assess the value of D-dimer in the detection of early VTE after TKA and THA. Materials and Methods: A total of 312 patients were evaluated in this retrospective study from 2016 to 2020 at a tertiary care centre, Mumbai who were operated for THA and TKA. The measurement of plasma D-dimer level was done preoperatively and clinically symptomatic patients were evaluated and confirmed for VTE by Colour Doppler Sonography. The plasma D-dimer levels were correlated statistically with the sonographic VTE. Results: 11 patients developed Deep Vein Thrombosis (DVT) and 1 patient developed Pulmonary embolism (PE). Preoperative plasma D-dimer levels were significantly higher (P developed dVT postoperatively. Colour doppler Sonography showed that 2 thrombi were seen in proximal veins (pelvic and femoral veins), and 2 thrombi were seen in distal veins (posterior tibial, peroneal, gastrocnemian veins) of the calf in THA patients, and all 8 thrombi were seen in the distal veins (posterior tibial, peroneal, gastrocnemian veins) of the calf in TKA patients. Conclusion: We infer that if the preoperative D-dimer levels were more than 0.5 mg/l, the chances of developing VTE postoperatively are more, which can be diagnosed clinically and further by other investigations. In this study, we have shown that doing preoperative d-dimer level can almost PREdICT the development of VTE and thus prevent complications.

关键词： plasma d-dimer dVT Colour doppler Clinical dVT Preoperative d-dimer TKA THA Early dVT

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Update in management of mesenteric ischemia

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World Journal of Gastroenterology 2006年第20期12卷 3243-3247页

作者： Robert W Chang John B Chang Walter E Longo Professor department of Surgery Yale University School of Medicine333 Cedar StreetNew Haven 06510United States

Mesenteric ischemia disorders are precipitated by a circulation insufficiency event that deprives one or several abdominal organs of adequate respiration to meet metabolic demands. Although mesenteric ischemia occurs infrequently, the mortality rate is from 60% to 100%, depending on the source of obstruction. The successful outcome is dependent upon a high index of suspicion and prompt management. We briefly review the pathophysiology and presentation of the various ischemic entities and review the current state of the art in diagnosis and treatment. despite advances in both diagnosis and treatment, prompt diagnosis and supportive care remain critical for successful outcome. New imaging techniques, endovascular therapy and emerging research may improve our approach to this deadly condition.

关键词： Mesenteric ischemia duplex ultrasonography plasma d-dimer Computed tomography

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The Clinical Value of NLR, d-d and CRP/ALB Ratio in the diagnosis of Pulmonary Thromboembolism

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Journal of Biosciences and Medicines 2021年第10期9卷 65-73页

作者： Tiantian Shan[] Zhen Cheng[] Min Yan Xiangtao Pan department of Hematology Taicang Hospital Affiliated to Soochow University Taicang China

Objective: To evaluate the clinical diagnostic value of C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR) and d-dimer (d-d) in patients with pulmonary thromboembolism (PTE). Methods: We conducted a retrospective analysis comparing hematology and coagulation in 362 PTCA-confirmed PTE patients with the control group and analyzing their relationships with CAR, NLR, and d-d. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic threshold, area under the curve (AUC), diagnostic sensitivity and specificity of CAR, NLR and d-d for PTE. Results: 1) CAR, NLR and d-d levels in PTE patients were 2.13 ± 2.08, 8.96 ± 1.94 and 9.69 ± 8.61 respectively, significantly higher than those in control group (CAR = 0.03 ± 0.01, t = 20.7736, P d PTE = 0.20 ± 0.11, t = 3.0066, P d with CAR (r = 0.2111, t = 4.0971, P d d-d (r = 0.1065, t = 2.0481, P d with d-d (r = 0.0975, P > 0.05). 3) The levels of HB, LY, PLT and AT in PTE patients were significantly lower than those in control group, while WBC, NE and FB were significantly higher than those in control group. 4) CAR was negatively correlated with Hb and AT (P all d with WBC, NE, MO and FB (P all d with LY and AT (P all d with WBC, NE and FB (P all dd was negatively correlated with Hb and PLT (P all d with WBC, NE and MO (P all Conclusion: The levels of Hb, LY, PLT and AT were significantly decreased in PTE patients, while WBC, NE and FB were significantly increased. CAR, NLR and d-d were highly expressed in PTE patients, and were closely correlated with Hb, AT and FB. Combined detection of CAR, NLR and d-d can improve the diag

关键词： Pulmonary Thromboembolism CAR C-Reactive Protein/Albumin Ratio Neutrophil to Lymphocyte Ratio plasma d-dimer Clinical diagnosis

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