title: D-dimer levels correlate with pathologic thrombosis in trauma patients.
abstract: Pathologic thrombosis, in the form of pulmonary embolism (PE) and deep venous thrombosis (DVT), causes significant morbidity and mortality in trauma patients and presents a diagnostic and therapeutic challenge because of associated conditions in these patients. This study examines the measurement of D-dimer crosslinked fibrin degradation products (D-dimer XDPs) as an indicator of hypercoagulability that places a trauma patient at risk of developing pathologic thrombosis. The time course of changes in D-dimer values after trauma normally involves an initial increase with a rapid decrease of D-dimer XDP levels to normal. Patients who then demonstrate a second rise in D-dimer values are at risk for pathologic thrombosis. Forty-one trauma patients were studied, in two groups, to evaluate the potential use of D-dimer XDP levels in evaluating the risk of pathologic thrombosis. A secondary increase in D-dimer XDP levels was found to occur in patients with PE, although sepsis and adult respiratory distress syndrome can also cause a late increase. However, D-dimer determinations appear to provide an easy, relatively inexpensive means of evaluating trauma patients for the risk of pathologic thrombosis.
authors.affiliation: Department of Traumatology, Hannover Medical School, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Schmidt
authors.forename: B L
authors.initials: BL
authors.lastname: Enderson
authors.forename: J P
authors.initials: JP
authors.lastname: Chen
authors.forename: K I
authors.initials: KI
authors.lastname: Maull
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D015601:Injury Severity Score; D007841:Latex Fixation Tests; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000097:blood; D015849:Plasminogen Inactivators / Q000097:blood; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000209:etiology; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood* / Q000209:etiology; D014947:Wounds and Injuries / Q000097:blood / Q000150:complications*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D015849:Plasminogen Inactivators; C036309:fibrin fragment D; D010960:Plasminogen Activators