Combination of Preoperative D-Dimer and Platelet Distribution width Predicts Postoperative Deep Venous Thrombosis in Patients with Cervical Carcinoma

Abstract

Background: Deep venous thrombosis (DVT) is associated with severe morbidity and mortality in cancer. Platelet<br />distribution width (PDW), a platelet index, indicates variation in platelet size. We aimed to investigate whether the<br />combination of D-dimer and PDW could have a better performance in predicting DVT in patients with cervical<br />carcinoma. Materials and Methods: In 198 consecutive cervical carcinoma patients without preoperative DVT,<br />preoperative D-dimer and PDW levels were measured. Compression ultrasonography was performed in all cervical<br />carcinoma patients before surgery, as well as one month, three months, six months, and 12 months. Results: During a<br />median period of 12 months, 17 of the 198 patients (8.6 %) developed DVT. PDW levels were reduced and D-dimer<br />levels were increased in patients with DVT events compared to those without DVT. Multivariate Cox analysis revealed<br />that both PDW and D-dimer were independent predictors for DVT events. The area under the ROC curve was 0.628<br />(95% CI: 0.556 to 0.695, p=0.142) when D-dimer was used alone, whereas it increased to 0.777 (95% CI: 0.712 to<br />0.833, p<0.011) with the addition of PDW. Incorporation of PDW into the D-dimer model significantly improved the<br />predictive value. Conclusions: The combination of preoperative D-dimer and PDW improves the predictive power of<br />postoperative DVT risk in patients with cervical carcinoma.