Diagnostic value of plasma D-dimer in venous thromboembolism caused by bone injury in patients with bone trauma

ObjectiveTo investigate the value of plasma D-dimer in the diagnosis of venous thromboembolism caused by bone injury in patients with bone trauma.

MethodsSeventy patients with bone injury were selected.According to the results of color Doppler ultrasonography, 20 patients with and 50 patients without venous thromboembolism were divided into the thrombosis group and bone injury group, respectively.Twenty healthy people at the same time were selected as the control group.The preoperative and postoperative D-dimer levels of all patients were detected, and analyzed using one-way ANOVA.The positive rate of D-dimer in patients with different fracture sites was analyzed.The positive rate between color Doppler ultrasonography and D-dimer were compared and analyzed on the seventh day after operation.The logistic regression analysis was used to analyze the relationship between D-dimer and venous thromboembolism.The value of D-dimer in predicting VTE after bone injury was analyzed using receiver operating characteristic curve.

ResultsThe preoperative D-dimer levels in thrombus group and bone injury group were significantly higher than that in control group(P < 0.05), and the postoperative D-dimer level in thrombus group was significantly higher than that in bone injury group(P < 0.01).The positive rates of D-dimer in patients with multiple fractures, pelvic fractures and lower limb fractures were higher than that in patients with upper limb fractures(P < 0.05), and the positive rate in patients with lower limb fractures was significantly higher than that in patients with other fracture sites(P < 0.05).On the seventh day after operation, the positive D-dimer in 24 patients were diagnosed, and 20 patients with venous thromboembolism were diagnosed by color Doppler ultrasound.The results of logistic regression analysis showed that the D-dimer level was an independent predictor of VTE(P < 0.01).The area under the receiver operating characteristic curve of the postoperative D-dimer level predicting VTE after bone trauma was 0.906(95%CI: 0.825-0.987).

ConclusionsThe determination of plasma D-dimer level is more sensitive to venous thromboembolism caused by bone injury in patients with bone trauma, which is helpful to predict early thrombosis in patients.