Usefulness of D-dimer and Ultrasonography Screening for Detecting Deep Vein Thrombosis in Patients with Spinal Cord Injury Undergoing Rehabilitation

• Published in: Journal of clinical medicine 2021-02, Vol.10 (4), p.689
• Main Authors: Mackiewicz-Milewska, Magdalena, Cisowska-Adamiak, Małgorzata, Pyskir, Jerzy, Świątkiewicz, Iwona
• Format: Article
• Language: English
• Subjects: Asymptomatic; Blood clots; Clinical medicine; Disease prevention; Edema; Pain; Paresis; Plasma; Rehabilitation; Spinal cord injuries; Thromboembolism; Thrombosis; Ultrasonic imaging; Urinary tract diseases; Urinary tract infections; Urogenital system; Veins & arteries
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10040689

Patients with spinal cord injury (SCI) are at an increased risk of deep vein thrombosis (DVT). This study aims at assessing usefulness of D-dimer and compressive Doppler ultrasonography (CDUS) for detecting DVT in patients undergoing rehabilitation at various time-points post-SCI. One-hundred forty-five patients were divided into three groups based on time elapsed since SCI: I (≥3 weeks to 3 months), II (≥3 to 6 months), and III (≥6 months). On admission, D-dimer plasma level measurement and CDUS of the lower limbs venous system were performed. DVT was diagnosed using CDUS in 15 patients (10.3% of entire group), more frequently in group I (22.2% of group) and II (11.7%) compared to group III (1.5%). Most DVT patients received thromboprophylaxis (80%) and were asymptomatic or mildly symptomatic (60%). Median D-dimer was elevated in patients with DVT from all groups, and also patients without DVT from groups I and II, but not group III. D-dimers were higher in patients with DVT than without DVT in the entire group ( = 0.001) and group I ( = 0.02), but not in groups II and III. The risk of DVT in SCI patients undergoing rehabilitation and thromboprophylaxis including asymptomatic or mildly symptomatic cases, is high within 6 months post-injury, and especially within 3 months. Measurement of D-dimer level should be complemented by routine CDUS for detecting DVT within 6 months post-SCI. Over 6 months, the usefulness of D-dimer screening alone is better for DVT detection.