Diagnostic value of the risk assessment profile for thromboembolism and plasma D-dimer level in deep vein thrombosis patients after periarticular ankle fractures

Objective: This study aimed to investigate the diagnostic value of the risk assessment profile for thromboembolism (RAPT) and plasma D-dimer in deep vein thrombosis (DVT) of patients with periarticular ankle fractures (PAF). Methods: A total of 85 patients who were treated due to PAF were retrospectively reviewed. After admission, patients were divided into middle to high risk group and low risk group according to the RAPT score. Results: Before surgery, DVT was found in 0 (0%) and 15 patients (22.39%) in low risk group and middle to high risk group, respectively (P<0.05). After surgery, DVT was found in 0 (0%) and 15 patients (19.44%) in low risk group and middle to high risk group, respectively (P>0.05). If 1.4 mg/L was used as a cut-off value of D dimer, the sensitivity and specificity were 87.5% and 4.3%, respectively, in the diagnosis of DVT of PAF patients. The AUC was the largest when the cut-off value of D dimer was 3.6 mg/L at which the sensitivity and specificity were 0.810 and 0.578, respectively. Conclusion: Patients with PAF have a risk for DVT in peri-operative period, with distal embolization as the major type. RAPT is associated with DVT before surgery, but not after surgery, in PAF patients. D-dimer has a low accuracy and a poor specificity in the diagnosis of DVT of PAF patients, and 3.6 mg/L is the optimal cut-off value of D-dimer in the diagnosis of DVT.