D-dimer-based screening for detecting preoperative venous thromboembolism in patients with musculoskeletal tumors: a retrospective study of 756 patients

Abstract

Abstract Malignant musculoskeletal tumors are considered high risk for venous thromboembolism, but the characteristics of venous thromboembolism in benign musculoskeletal tumors are unclear. We evaluated D-dimer as a screening preoperative test in patients with benign and malignant musculoskeletal tumors to determine the prevalence and risk factors for venous thromboembolism and the utility of D-dimer in the diagnosis of venous thromboembolism. A total of 756 patients, 328 with malignant and 428 with benign, were evaluated for thrombosis by preoperative D-dimer and imaging. Medical data were analyzed retrospectively to determine the prevalence of venous thromboembolism, risk factors and diagnostic accuracy of D-dimer. The prevalence of venous thromboembolism in patients with malignant and benign musculoskeletal tumors was 11.3% and 1.6%, respectively. For malignant tumors, age >60 years, lower extremities, hypertension, and hepatobiliary-pancreatic disease were risk factors for venous thromboembolism, while for benign tumors, pathologic fracture and D-dimer were risk factors for venous thromboembolism. The prevalence of VTE was higher in patients with malignant tumors than in patients with benign tumors, and malignancy was a risk factor for VTE development in musculoskeletal tumors. D-dimer was useful in ruling out VTE in both benign and malignant musculoskeletal tumors, with particularly high diagnostic accuracy in benign tumors.