The utility of D-dimer levels in screening for thromboembolic complications in burn patients

Abstract

Recent studies confirm that thromboembolic complications in burn patients are higher than previously reported. Swelling, pain, and erythema are not useful indicators of deep venous thrombosis (DVT) in burned extremities. We propose that D-dimer levels may be useful in determining which patients would benefit from further screening for DVT. Thirty adult hospitalized burn patients were screened for DVT with duplex ultrasound on admission and then weekly until discharge. D-dimer levels were measured at the same intervals. Seven patients developed 11 cases of DVT. The mean time to DVT diagnosis was 6.7 days. D-dimer levels were elevated in 86% of DVT patients at week 1, with a negative predictive value of 94%. The evaluation of elevated D-dimer levels at week 1 may be a useful screening tool for detecting DVT in the burn population.