Utility of postoperative plasma D-Dimer testing for early prediction of venous thromboembolism after pancreatectomy: A retrospective study

Early detection of venous thromboembolism (VTE) is crucial to prevent disastrous outcomes after major abdominal surgery. This study aimed to investigate whether D-dimer testing can predict the incidence of VTE after major pancreatectomy. The medical records of patients who underwent major pancreatectomy between June 2018 and March 2021 at Kobe University Hospital were retrospectively reviewed. Plasma D-dimer levels were measured repeatedly after surgery. The ability of D-dimer to predict VTE was determined using receiver operating characteristic curve analysis. Data from 234 patients (median age, 69 years) were analyzed. Twenty-two patients (9.4 %) were diagnosed with VTE (pulmonary embolism, 2.1 %; deep venous thrombosis [without concomitant pulmonary embolism], 3.4 %; portal venous thrombosis, 3.0 %). Age >70 years was an independent risk factor in multivariate analysis. Plasma D-dimer levels on postoperative days 0, 1, 3, 5, and 7 were significantly higher in patients with VTE than in those without VTE. Plasma D-dimer levels on postoperative days 3, 5, and 7 demonstrated good predictive ability to detect VTE (area under the curve: 0.77, 0.79, and 0.79, respectively) with cutoff values of 8.9 (sensitivity, 0.73; specificity, 0.77), 16.6 (sensitivity, 0.64; specificity, 0.85), and 14.2 (sensitivity, 0.77; specificity, 0.71) μg/mL, respectively. Plasma D-dimer levels on postoperative days 3–7 may be useful in the early detection of VTE.