D-dimer screening for @entity1150 in traumatic cervical XXXX .

@entity1 @entity3510 @entity1003 @entity1150 @entity1566 @entity912
BACKGROUND CONTEXT: @entity1150 ( @entity1150 ) in @entity1566 ( @entity1566 ) @entity1 is a life-threatening comorbidity. Despite its seriousness, prophylaxis and screening for @entity1150 in @entity1566 @entity1 are still not sophisticated. PURPOSE: This study aimed to define the epidemiology and incidence of @entity1150 in acute traumatic cervical @entity1566 in a Japanese population, determine the best timing for @entity1150 screening, and determine the optimal D-dimer threshold level for use as an easy and minimally invasive screening tool. STUDY DESIGN: This is a prospective clinical study. @entity1 SAMPLE: The @entity1 sample included acute traumatic cervical @entity1566 @entity1 who were admitted to our facility within 2 weeks after injury. OUTCOME MEASURE: Multivariate logistic regression was performed for outcome measure. METHODS: We enrolled 268 @entity1 (223 @entity1 and 45 @entity1 ), from April 2007 to December 2012. After excluding early drop-out @entity1 , 211 @entity1 remained. Assessment for neurological status and blood chemistry, especially @entity1003 levels (prothrombin time, prothrombin time-international normalized ratio, activated partial thromboplastin time, and serum D-dimer), was performed every week until 1 month after injury. Ultrasonography was performed for @entity1150 detection every 2 weeks. RESULTS: @entity1150 were detected in 22 @entity1 (10.4% of @entity1 studied). All @entity1150 -positive @entity1 demonstrated severe @entity912 classified as C or greater on the American @entity3510 Association (ASIA) Impairment Scale. Multivariate logistic regression of clinical and laboratory parameters revealed that only the D-dimer level at 2 weeks after injury was an accurate predictor of @entity1150 formation. The optimal threshold of D-dimer for prediction was determined to be 16  g/dL. The sensitivity and specificity for detecting @entity1150 were 77.3% and 69.2%, respectively. CONCLUSIONS: D-dimer levels may be used to predict the likelihood of @entity1150 development in @entity1 with acute cervical @entity1566 . Furthermore, the optimal timing for screening test by D-dimer is 2 weeks after injury, and optimal threshold level for D-dimer for diagnosing @entity1150 is 16  g/dL. Such a screening test would be cost-efficient and simple to administer and could then be followed with additional investigations, such as ultrasonography or venography.
