SADA-15 D-DIMER AS A SENSITIVE PREDICTOR OF PERIOPERATIVE VTE RISK IN SURGICAL SPINE ONCOLOGY PATIENTS
Seeley Yoo, Tara Dalton, Ramzy Ahmed, Emmy Duerr, Brandon Lee, Ezinne Oguguo, Kerri-Anne Crowell, Eli Johnson, Julia Duvall, Muhammad M Abd- El-Barr, Melissa Erickson, C Rory GoodwinAbstract
Introduction
Venous thromboembolism (VTE) represents a serious perioperative complication following spine surgery, with pulmonary embolism (PE) carrying mortality rates as high as 19%. Patients with spinal tumors are at particularly high risk; however, reliable predictors and screening strategies for VTE in this population remain poorly defined.
Methods
A retrospective review was conducted of adult patients undergoing spine surgery between January 2021 and September 2024. Preoperative D-dimer levels were compared between patients who developed VTE and those who did not. Additional variables included age, sex, tumor type, spinal level, and ambulatory status. Group differences were analyzed using chi-square tests for categorical variables and t-tests or Mann-Whitney U tests for continuous variables. Receiver operating characteristic (ROC) analysis was performed to evaluate the predictive performance of D-dimer, with area under the curve (AUC) calculated and optimal cutoff determined using the Youden Index. Data are presented as mean ± standard deviation.
Results
Among 134 patients, the incidence of deep vein thrombosis (DVT) was 6.7% and pulmonary embolism (PE) was 9.0%. Patients who developed PE had significantly higher preoperative D-dimer levels compared to those who did not (2,088 ± 2,114 ng/mL vs. 1,222 ± 1,743 ng/mL, p = 0.025). No significant associations were observed between D-dimer and DVT or between VTE risk and age, sex, tumor type, spinal level, or ambulatory status. Preoperative D-dimer demonstrated a sensitivity of 0.88, negative predictive value of 0.97, and an AUC of 0.67 (95% CI, 0.55–0.78) for predicting VTE.
Conclusions
Preoperative D-dimer is a sensitive but non-specific marker for VTE in patients undergoing surgery for spinal tumors, with greater predictive utility for PE than DVT. These findings support its potential role as a screening tool to inform perioperative anticoagulation strategies in this high-risk population.