Abstract
Study design
Article.
Objective
To elucidate the association of age-adjusted D-dimer (AAD) with deep vein thrombosis (DVT) risk to lower limbs in patients with spinal cord injury (SCI).
Setting
Rehabilitation Medicine Department of the First Affiliated Hospital of China University of Science and Technology.
Methods
Retrospective analysis of 250 patients with SCI in the rehabilitation department from August 2018 to December 2021. Quartiles divided the D-dimer level into four groups to analyze the association between AAD level and DVT risk.
Results
Age was identified as a covariate of D-dimer and DVT risk. For non-adjusted model, when D-dimer increased by 1 mg/L, DVT risk increased 0.23-fold (P < 0.05); for minimally-adjusted model (adjusted for age), the risk increased 0.22-fold (P < 0.05); and for fully-adjusted model (adjusted for age, sex, pulmonary infection, degree, grades, and career), it increased 0.19-fold (P < 0.05). AAD had a curvilinear association with DVT risk, and the fold point was 1.9 mg/L (P < 0.05). When serum AAD level was <1.9 mg/L (K < 1.9), the estimated change in DVT risk was 3.34 (P < 0.05), and when serum AAD level was >1.9 mg/L (K > 1.9), the estimated change was 1.14 (P < 0.05). Urinary tract infection (UTI) and fibrinogen(tertile) had a interaction association with D-dimer level and DVT risk (P interaction < 0.05).
Conclusion
Patients with SCI who receive rehabilitation treatment with AAD level >1.9 mg/L need to be paid close attention to, especially those with UTI and high levels of fibrinogen.
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Data and materials availability
The datasets analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We sincerely thank Tingting Zhang, CuicuiChang, Tingting Bao, Nanzu Chengjiang, Liai Sun, and Lina Ma for collecting and sorting participants’ data. We also thank Yan Huang, Chaomin Ni, and Ming Wu for providing the train of studying thought. We also thank Xinglin Chen for helping us to analyze the data. We would like to thank Editage (www.editage.com) for English language editing.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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JLZ: Conducted the study and wrote the draft. YYF: Designed the study, interpreted the data, and edited the manuscript. HYP, YT, JZ, and SSZ: Collected the data. CW: Planned the project, created and statistical analyzed the data. The authors all read and approved the final manuscript
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Informed consent was waived due to the nature of the retrospective study for participants, which coincident with ethical requirements and waiver from the ethics committee, the study approved by Ethics Committee of First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital), the approved number was 2020-RE-008.
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Zhang, J., Fang, Y., Pang, H. et al. Association of age-adjusted D-dimer with deep vein thrombosis risk in patients with spinal cord injury: a cross-sectional study. Spinal Cord 60, 90–98 (2022). https://doi.org/10.1038/s41393-021-00647-z
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DOI: https://doi.org/10.1038/s41393-021-00647-z
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