Key result
Higher preoperative D-dimer predicts post-op PE but shows modest overall accuracy for VTE.
Why the study?
Reliable predictors and screening strategies for perioperative VTE in patients with spinal tumors undergoing surgery remain poorly defined.
Does preoperative D-dimer measurement predict perioperative VTE risk in adult patients undergoing surgery for spinal tumors?
Cohort (n=134)
Does preoperative D-dimer measurement predict perioperative VTE risk in adult patients undergoing surgery for spinal tumors?
Preoperative D-dimer serves as a sensitive but non-specific screening marker for identifying high risk of perioperative venous thromboembolism, particularly pulmonary embolism, in spinal tumor surgery patients.
Answers are grounded in this paper and cite their sources.
Highlights VTE risk in neuro-oncology; leaves open optimal prophylaxis and risk-stratification strategies.
Introduction Venous thromboembolism (VTE) represents a serious perioperative complication following spine surgery, with pulmonary embolism (PE) carrying mortality rates as high as 19%. Patients with spinal tumors are at particularly high risk; however, reliable predictors and screening strategies for VTE in this population remain poorly defined. Methods A retrospective review was conducted of adult patients undergoing spine surgery between January 2021 and September 2024. Preoperative D-dimer levels were compared between patients who developed VTE and those who did not. Additional variables included age, sex, tumor type, spinal level, and ambulatory status. Group differences were analyzed using chi-square tests for categorical variables and t-tests or Mann-Whitney U tests for continuous variables. Receiver operating characteristic (ROC) analysis was performed to evaluate the predictive performance of D-dimer, with area under the curve (AUC) calculated and optimal cutoff determined using the Youden Index. Data are presented as mean ± standard deviation. Results Among 134 patients, the incidence of deep vein thrombosis (DVT) was 6.7% and pulmonary embolism (PE) was 9.0%. Patients who developed PE had significantly higher preoperative D-dimer levels compared to those who did not (2,088 ± 2,114 ng/mL vs. 1,222 ± 1,743 ng/mL, p = 0.025). No significant associations were observed between D-dimer and DVT or between VTE risk and age, sex, tumor type, spinal level, or ambulatory status. Preoperative D-dimer demonstrated a sensitivity of 0.88, negative predictive value of 0.97, and an AUC of 0.67 (95% CI, 0.55–0.78) for predicting VTE. Conclusions Preoperative D-dimer is a sensitive but non-specific marker for VTE in patients undergoing surgery for spinal tumors, with greater predictive utility for PE than DVT. These findings support its potential role as a screening tool to inform perioperative anticoagulation strategies in this high-risk population.
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Yoo et al. (2026) conducted a cohort in Spinal tumors requiring surgery (n=134). Preoperative D-dimer level vs. Patients who did not develop PE / lower D-dimer levels was evaluated on Preoperative D-dimer levels in patients who developed PE vs those who did not (AUC 0.67, 95% CI 0.55-0.78, p=0.025). Preoperative D-dimer was significantly higher in patients who developed PE than those who did not (2,088 vs 1,222 ng/mL, P=0.025), and predicted VTE with an AUC of 0.67 (95% CI 0.55-0.78).
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