Future direction: novel inflammatory markers to enhance deep vein thrombosis diagnostic specificity

R. Cohen, E. Daniel, S. Nemet, N. Abu Hamdeh, A. Mahamid, A. Kirzhner, T. Schiller, M. Alnees, H. Abu Khadija

Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. Haitham2048@yahoo.com

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• Atherosclerosis

OBJECTIVE: Deep vein thrombosis (DVT) poses a critical health risk, especially among the elderly. This study aims to enhance the specificity of DVT diagnosis by integrating novel inflammatory ratios and hematological markers.

MATERIALS AND METHODS: We conducted a retrospective cohort study at Kaplan Medical Center, analyzing data from 310 patients aged 65 and older, following strict inclusion and exclusion criteria. Hematological and biochemical parameters, including D-dimer, C-reactive protein (CRP), and various inflammatory markers, were evaluated. Statistical analyses involved logistic regression, Receiver operating characteristic (ROC) curve, and K-Nearest Neighbors (KNN) algorithm for missing data imputation, ensuring robust results for DVT diagnostics.

RESULTS: Out of 500 patients aged 65 and older evaluated for DVT admitted to the Emergency room at Kaplan Medical Center between January 1, 2020, and January 30, 2023, 310 were included in the analysis, with 23.23% positive for DVT. The DVT group’s mean age was significantly higher (78.6 ± 9.1 years) than the non-DVT group (76.4 ± 4.65 years, p < 0.01). Significant predictors of DVT included D-dimer (p < 0.01, OR 1.33) and the D-dimer to activated partial thromboplastin time (aPTT) ratio (p < 0.01, OR 1.07). While achieving 100% sensitivity for both markers comes with low specificity, D-dimer and the Dd:aPTT ratio demonstrated strong potential in identifying DVT.

CONCLUSIONS: D-dimer to aPTT ratio is a promising diagnostic tool for DVT, warranting further investigation.

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