Correlation Between D-Dimer Level and Deep Venous Thrombosis in Patients With Acute Spinal Cord Injuries

Am J Phys Med Rehabil, 2020 · DOI: 10.1097/PHM.0000000000001383 · Published: July 1, 2020

Spinal Cord Injury Cardiovascular Science

Simple Explanation

Venous thromboembolism is a serious complication after spinal cord injury (SCI). D-dimer levels are commonly tested to screen for deep vein thrombosis (DVT). However, factors like trauma and motor weakness, which are often present in SCI patients, can affect D-dimer levels, making interpretation difficult. This study investigates how D-dimer levels correlate with DVT in acute SCI patients, considering the presence of comorbidities like trauma and motor weakness. The goal is to understand how these factors influence D-dimer levels and their usefulness as a screening tool. The study found that while D-dimer levels can be helpful for screening, they have limitations in predicting DVT in acute SCI patients. Trauma and lower limb motor weakness significantly affect D-dimer levels and should be considered when interpreting the results.

Study Duration

Not specified

Participants

45 patients with acute spinal cord injuries

Evidence Level

Retrospective observational study

Key Findings

1
D-dimer levels decrease over time after spinal cord injury onset.
2
Lower limb motor index scores significantly correlated with D-dimer levels, indicating that greater motor weakness in the lower limbs is associated with increased D-dimer levels.
3
Patients with traumatic SCI had significantly higher D-dimer levels compared to those with nontraumatic SCI.

Research Summary

This retrospective study examined the correlation between D-dimer levels and deep vein thrombosis (DVT) in 45 patients with acute spinal cord injuries (SCI). The study aimed to determine if D-dimer levels were a useful screening parameter for DVT, considering comorbidities such as trauma and motor weakness. The results showed that D-dimer levels decreased over time after SCI onset, and lower limb motor weakness was significantly correlated with D-dimer levels. Traumatic SCI patients had significantly higher D-dimer levels compared to nontraumatic SCI patients. The study concluded that while D-dimer levels have limitations in the positive prediction of DVT in acute SCI, it is a useful screening tool. Trauma and lower limb motor weakness should be considered when analyzing D-dimer levels.

Practical Implications

D-dimer Screening

D-dimer can be used as a screening tool for early detection of venous thromboembolism in acute SCI patients.

Consider Comorbidities

When interpreting D-dimer levels in acute SCI patients, clinicians should consider the presence of trauma and the degree of lower limb motor weakness.

Further Investigation

If D-dimer levels are high and lower limb motor weakness is severe, physicians should investigate both venous thromboembolism in the lower limbs and pulmonary embolism.

Study Limitations

1
Pulmonary embolism evaluations were not conducted.
2
The D-dimer test was not performed consistently at the same time point for all patients.
3
Only D-dimer values were interpreted during DVT diagnosis.

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