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January 1, 1998Thrombosis and Haemostasis

Clinical Utility of Prothrombin Fragment 1+2, Thrombin Antithrombin III Complexes and D-dimer Measurements in the Diagnosis of Deep Vein Thrombosis following Total Hip Replacement

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Why the study?

Do measurements of F1+2, TAT, and D-dimer accurately rule out postoperative DVT in patients undergoing total hip replacement under antithrombotic prophylaxis?

Population

159 patients undergoing total hip replacement under antithrombotic prophylaxis

Comparison

Measurement of prothrombin fragment 1+2… vs Bilateral venography performed 8-11 days after…

Design

Cohort, randomized (parent trial), double-blind (parent trial)

Follow-up

8-11 days after surgery

Authors

ECE. CofrancescoUniversity of MilanACA CorradiUniversity of TurinFRF. RavasiASST Melegnano e della Martesana

Discussion

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Implication

F1+2 and D-dimer lack adequate sensitivity to exclude postoperative DVT; leaves open whether alternative markers improve rule-out accuracy under prophylaxis.

Structured PICO

Do measurements of F1+2, TAT, and D-dimer accurately rule out postoperative DVT in patients undergoing total hip replacement under antithrombotic prophylaxis?

P
Population
159 patients undergoing total hip replacement under antithrombotic prophylaxis (desirudin 10, 15, or 20 mg b.i.d. or unfractionated heparin 5000 IU t.i.d.)
I
Intervention
Measurement of prothrombin fragment 1+2 (F1+2), thrombin antithrombin III complexes (TAT), and D-dimer plasma levels at baseline and postoperative days 1, 3, and 6
C
Comparator
Bilateral venography performed 8-11 days after surgery
O
Outcome
Diagnostic efficacy (sensitivity and negative predictive value) to rule out postoperative deep venous thrombosis (DVT)surrogate

Measurements of F1+2, TAT, and D-dimer lack sufficient sensitivity and negative predictive value to safely rule out DVT in patients receiving antithrombotic prophylaxis after total hip replacement.

Cite This Study

Cofrancesco et al. (1998) studied this question.

synapsesocial.com/papers/6a7c8dc2e7df423ee14c714chttps://doi.org/10.1055/s-0037-1614934

Topics

Anticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Coagulation Activation Markers in the Prediction of Venous Thrombosis after Elective Hip Surgery1997 · 49 citations
  2. 2Thrombin-Antithrombin III Complexes in the Prediction of Deep Vein Thrombosis Following Total Hip Replacement1989 · 37 citations
  3. 3D-Dimer in the Diagnosis of Deep Vein Thrombosis Following Total Hip and Knee Replacement: A Prospective Study2008 · 31 citations
  4. 4Pre-operative Plasma Levels of Thrombin-Antithrombin III Complexes Correlate with the Development of Venous Thrombosis after Major Hip or Knee Surgery1995 · 44 citations
  5. 5Evaluation of soluble fibrin and D-dimer in the diagnosis of postoperative deep vein thrombosis2009 · 25 citations