ANALYSIS OF D-DIMER VALUES IN POST-OPERATIVE PATIENTS OF MAJOR HIP AND KNEE SURGERY
Background: Measurement of D-dimer has been established as an effective indirect indicator of thrombotic activity. Many studies have indicated role of D-dimer values in post-operative patients for early diagnosis of Deep Vein Thrombosis. In our study we obtained and evaluated D dimer values in Indian patients and compared it with existing literatures. Methods: Total 50 patients were selected who were planned for major hip and knee surgeries. D-dimer values were obtained one day prior to surgery, post-operative days 1, 3, 5, 7 and 14th day. B Mode ultrasound and color Doppler was done in all patients for the exclusion of DVT on post-operative day 7. Results: The D-dimer values were found to be sharply elevated and peaked at the post-operative day one, then gradually decreased to near baseline level by 7th day and continued to be in the same range till 14th day. Our study did not show a second peak in D-dimer values. No confirmed case of DVT was reported based on venous Doppler ultrasound. Conclusion: The first peak of D-dimer on post-operative day 1 could be attributed to the tissue injury due to surgical trauma. The second peak which comes around day 7 is more likely to corroborate with impending DVT. We concluded in our study that Indian patients undergoing major hip and knee surgeries tend to have a low risk of DVT, as compared to western studies.
Deep Venous Thrombosis; D-Dimer; Arthroplasty; Major Hip and Knee Surgery.