The value of the D-Dimer assay for predicting vein thrombosis in rehabilitation patients receiving prophylactic low molecular weight heparin doses.
OBJECTIVE
Early diagnosis and treatment of venous thrombosis biocontact="no" are essential in preventing pulmonary embolism (PE) and reducing the risk of recurrence. The objective was to assess the usefulness of the D-Dimer testing to rule out symptomatic VT in populations of patients receiving heparin in prophylactic doses.


METHODS
One hundred and twenty-three rehabilitation patients with medium or high risk for VT were investigated. Patients were affected by acquired cerebral diseases (n=31), severe brain damage (n=32) or orthopaedic surgical sequelae for major joint replacement or multiple limb fractures (n=60). All patients were receiving prophylactic heparin doses. D-Dimer levels were assessed using Dimertest Latex Agglutination Assay in citrated plasma. Single blinded compression Doppler Ultrasound (DUS) examination was performed in conformity with international standards.


RESULTS
In this specific setting, good sensitivity and specificity of the D-Dimer test was confirmed in patients with acquired cerebral diseases during rehabilitation, whereas false positive results were found in most patients who had undergone major joint replacement, until several weeks after surgery.


CONCLUSIONS
In rehabilitation patients receiving prophylactic heparin doses, the D-Dimer test seems to confirm high sensitivity and high negative predictive value for VT and PE. Relevant clinical variables seem to reduce the usefulness of the D-Dimer test as a screening tool for VT, at least in orthopaedic patients with joint prosthesis.
Formisano
R
R
IRCCS Santa Lucia Foundation, Rome, Italy. r.formisano@hsantalucia.it
Buzzi
M G
MG
Cicinelli
P
P
Voogt
R
R
Rinnenburger
D
D
Morelli
D
D
Terziani
A
A
Sanguigni
S
S
Di Lorenzo
L
L
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001925:Brain Damage, Chronic / Q000150:complications / Q000188:drug therapy / Q000534:rehabilitation*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007841:Latex Fixation Tests / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic / Q000592:standards*; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications / Q000188:drug therapy; D000071939:Stroke Rehabilitation; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; D011933:Reagent Kits, Diagnostic; C036309:fibrin fragment D