D-dimer from central and peripheral blood samples in asymptomatic central venous catheter-related thrombosis in patients with cancer.
Phlebology. 2019 Feb;34(1):52-57
Authors: Nañez-Terreros H, Jaime-Perez JC, Muñoz-Espinoza LE, Camara-Lemaroy CR, Ornelas-Cortinas GE, Ramos-Dena RD, Gonzalez-Guerrero JF, Nangullasmu-Plasencia T, Gonzalez-Escamilla M, Chipuli-Lopez O
OBJECTIVES: To evaluate the usefulness of a negative D-dimer in peripheral or central venous blood to screen for asymptomatic catheter-related thrombosis in cancer patients.
METHODS: D-dimer was measured in blood from central venous catheter and peripheral venous samples in 48 patients with cancer. Asymptomatic catheter-related thrombosis was identified via Doppler ultrasound. Bland and Altman's limits of agreement analysis was used to compare sample sites. Sensitivity and specificity of D-dimer was calculated.
RESULTS: Overall, 33 of the central samples and 32 of the peripheral samples had D-dimer levels below the cutoff (≥0.3 mg/l). Mean central D-dimer was 0.31 ± 0.35 mg/l; peripheral 0.24 ± 0.22 mg/l (p = 0.5). Bland-Altman plot showed that the two sample sites were not equivalent. Catheter-related thrombosis was demonstrated in five patients, and there were three false negatives. Peripheral D-dimer had a negative predictive value of 90.9%.
CONCLUSIONS: A negative D-dimer may be useful for screening asymptomatic catheter-related thrombosis in patients with cancer, but the central and peripheral sample sites are not equivalent.
PMID: 29690838 [PubMed - indexed for MEDLINE]