THE RELATIONSHIP OF D-DIMER LEVELS WITH RISK FOR DEVELOPING DEEP-VEIN THROMBOSIS AND/OR PULMONARY THROMBOEMBOLISM AFTER ORTHOPAEDIC TRAUMA SURGERY

MA Naeem, M Usman, MK Latif, M Aamir

Abstract


Background: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are common
complications in trauma patients. Fibrin-related markers (FRMs), such as fibrin and fibrinogen
degradation products (FDPs), D-dimer, and soluble fibrin (SF), are considered to be useful for the
diagnosis of thrombosis (DVT). Objective: We report on 3-month follow-up of fibrinolytic activity
after Orthopaedic Trauma Surgery (OTS). Methods: Patients who entered the study were divided
into (group 1) patients who did not develop DVT/PE after OTS while patients who developed
DVT/PE were included in (group 2). Blood samples were obtained on day of surgery and
postoperative days 1, 7 and 30, and assayed for blood counts, C-reactive protein (CRP), and Ddimers. Demographic and clinical data were also collected. Results: Postoperative levels of Ddimers of both groups increased on day 1, and remained elevated on day 30. Postoperative levels of
D-dimers on day 1, 7 and 30 were higher in group 2 (p<0.05). There were no differences in
perioperative levels of CRP between groups, and they correlated with D-dimers both preoperatively
and on day 30. Taken together, these data suggest that orthopaedic trauma surgery induced an
activation of coagulation and fibrinolysis. This situation lasts at least as late as 30 days after surgery.
Conclusion: The D-dimer levels were significantly higher in patients developing DVT/PE post OTS.
Keywords: D-dimer, DVT, Deep Vein Thrombosis, Pulmonary Embolism

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