Changes of perioperative D-dimer in patients with spinal degeneration and its predictive value for deep venous thromboembolism

Objective To investigate the changes of perioperative D-dimer in patients with spinal degeneration and its predictive value for deep venous thromboembolism. Methods A total of 200 patients with spinal degenerative disease undergoing surgical treatment in our hospital from January,2013 to December,2015 were enrolled and assigned into observation group (deep vein thromboembolism group) and control group (without deep venous thromboembolism).The plasma D-dimer levels were tested and the deep venous thrombosis was detected by color Doppler ultrasonography. Results The levels of plasma D-dimer on d₁,d₃ and d₇ after the operation were (1.76±0.23)μg/ml,(2.32±0.41)μg/ml and (1.67±0.35)μg/ml in the observation group,and (1.28±0.31)μg/ml,(1.26±0.27)μg/ml and (1.31±0.23)μg/ml in the control group,which were higher than those before the operation[(0.68±0.14)μg/ml in the observation group and (0.74±0.15)μg/ml in the control group],P<0.05.There was no significant difference in the plasma D-dimer level before the operation between the two groups (P>0.05).The plasma D-dimer level at d1,d3 and d7 after the operation in the observation group were significantly higher than those in the control group,the difference was significant (P<0.05).The ROC curve of D-dimer level in diagnosis of deep venous thromboembolism showed that the cutoff value was 1.17 μg/ml,the area under the ROC curve was 0.928,the 95% confidence interval had a lower limit of 0.890 and an upper limit of 0.966.When D-dimer ≥ 1.17 μg/ml was as deep vein thrombosis positive,D-dimer<1.17 μg/ml as deep vein thromboembolism negative for diagnosis of deep vein thromboembolism,the sensitivity was 92.9%,the specificity was 79.1%,the misdiagnosis rate was 20.9%,the missed diagnosis rate was 7.1%,the total compliance rate was 13.0%+68.0%=81.0%,Youden index was 72.0%,positive predictive value was 41.9% and negative predictive value was 98.6%. Conclusion The postoperative level of D-dimer in patients with spinal degeneration will increase,and the level of D-dimer has some prognostic value for deep venous thromboembolism.