J Korean Orthop Assoc.  2006 Feb;41(1):103-109.

Incidence of Deep Vein Thrombosis after Major HipSurgery and Diagnostic Value of D-dimer

Affiliations
  • 1Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea. drkim@khmc.or.kr
  • 2Department of Diagnostic Radiology, School of Medicine, Kyung Hee University, Seoul, Korea.

Abstract

PURPOSE
To evaluate the incidence of deep vein thrombosis (DVT) after major hip surgery along with the efficacy of the D-dimer as a routine noninvasive-screening test for DVT.
MATERIALS AND METHODS
From May 2003 to August 2004, 289 patients who underwent major hip surgery were evaluated prospectively. All the patients underwent B-mode ultrasonography (US) preoperatively, and venography or US on postoperative 7 to 10 days. The D-dimer level was also estimated preoperatively, and at 3 and 7 days after surgery.
RESULTS
The preoperative D-dimer level was an average 0.60 ug/ml. DVT was encountered in 29 patients (10.1%) and in 28.9% of those over 60 years of age (p<0.05). Three days after surgery, the average D-dimer level was 3.82 ug/ml in the DVT positive patients and 2.26 ug/ml in the DVT negative patients. Seven days after surgery, the average D-dimer level in the DVT positive and negative patients was 5.19 ug/ml and 2.89 ug/ml. The most predictable D-dimer level for DVT 3 and 7 days after surgery were 2.585 ug/ml and 3.625 ug/ml, respectively.
CONCLUSION
The overall incidence of DVT in our patients undergoing major hip surgery seemed lower than in Western populations. However, there was a significantly increasing tendency if the development of DVT in the older age group. We also recommend a D-dimer assay at postoperative 7 days as a valuable screening test for detection of DVT.

Keyword

Hip; Deep vein thrombosis; D-dimer; Venography; Ultrasonography
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