Clin Lab. 2024 Aug 1;70(8). doi: 10.7754/Clin.Lab.2024.240133.
D-dimer is used as a clinical indicator to predict venous thromboembolism, and some hospitals have included it in the critical value project. We aimed to evaluate whether the setting of a D-dimer critical value is helpful in the diagnosis of deep vein thrombosis in patients with bone trauma and to explore the rationality of setting a D-dimer critical value limit.
The clinical data of 4,897 bone trauma patients, hospitalized from April 1, 2022, to March 31, 2023, were retrospectively analyzed. Our hospital set the critical value limit for when the D-dimer value was greater than 15.0 mg/L, and Bayesian model was used to evaluate the relationship between deep vein thrombosis and the D-dimer limit.
During this period, 199 times the D-dimer detection value was greater than 15.0 mg/L, and the critical value was reported and accounted for 4.06%. The predicted probability of lower limb venous thrombosis in patients who triggered the critical value of D-dimer was 40.21%, and the actual incidence was 34.67%. There were 376 patients with lower limb venous thrombosis during hospitalization, and 81.38% of the D-dimer value did not reach the critical value limit.
The role of D-dimer as a critical value item in predicting DVT in patients with orthopedic trauma is small. Whether to list D-dimer as a critical value item can be comprehensively considered according to the own situation of medical institutions and the recommendations of clinicians. The same can be applied for the setting of critical value boundaries.
D-二聚体作为一种临床指标用于预测静脉血栓栓塞症，部分医院已将其纳入危急值项目。本研究旨在评估在骨创伤患者中设置 D-二聚体危急值界限是否有助于诊断深静脉血栓，并探讨设置 D-二聚体危急值界限的合理性。
回顾性分析 2022 年 4 月 1 日至 2023 年 3 月 31 日期间收治的 4897 例骨创伤患者的临床资料。我院将 D-二聚体值大于 15.0 mg/L 时设置为危急值界限，采用贝叶斯模型评估深静脉血栓与 D-二聚体界限的关系。
在此期间，199 次 D-二聚体检测值大于 15.0 mg/L，危急值报告占 4.06%。触发 D-二聚体危急值的患者下肢静脉血栓的预测概率为 40.21%，实际发生率为 34.67%。住院期间共 376 例患者发生下肢静脉血栓，81.38%的 D-二聚体值未达到危急值界限。
D-二聚体作为骨创伤患者预测 DVT 的危急值项目的作用较小。是否将 D-二聚体列为危急值项目可根据医疗机构自身情况和临床医生的建议综合考虑。危急值界限的设置也同样如此。
