Correlation of Wells Score, Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen and D-Dimer Levels with Doppler Ultrasonography in Suspected Deep Vein Thrombosis Patients


  •  Erny Alasiry    
  •  Andi Fachruddin Benyamin    
  •  Sahyuddin Saleh    
  •  Syakib Bakri    
  •  Muhammad Ilyas    
  •  Hasyim Kasim    
  •  Idar Mapangara    
  •  Arifin Seweng    

Abstract

BACKGROUND/AIM: Venous thromboembolism (VTE) occur from formation of blood clots in the veins, which are mostly composed of fibrin and red blood cells with a small component of leukocytes and platelets. Most VTE manifests as deep vein thrombosis (DVT) and pulmonary embolism (PE). The lack of availability of Doppler ultrasound in health facilities especially in remote areas, makes the diagnosis of DVT challenging. There for, history taking, physical examination and laboratory findings are very important in diagnosing DVT especially in those area where Doppler ultrasound unavailable. Based on this we study the correlation Wells scores, Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen, and D-Dimer levels with the findings on Doppler ultrasound in patients with suspected DVT in Wahidin Sudirohusodo Hospital Makassar.

METHOD: The study was conducted in Department of Internal Medicine, Wahidin Sudirohusodo Hospital Makassar from 2018 to 2019. Subjects were inpatients in Department of Internal Medicine with DVT suspicion. Wells scores, PT, APTT, Fibrinogen, D-Dimer levels and Doppler ultrasound results of all subjects were recorded and then analyzed. The patient is DVT positive if confirmed by Doppler Ultrasonography. Statistical analysis was performed by descriptive statistical calculations and frequency distribution as well as the Independent-t statistical test, Chi Square test and Fisher Exact test.

RESULTS: Among 38 subject, 24 were men (63.2%) and 14 were women (36.8%). We found higher Wells score, shortened PT and APTT, increased fibrinogen in subject with positive Doppler ultrasound, without a significant correlation. A significant correlation was found between increased D-Dimer levels positive Doppler ultrasound results (79.4%, p = 0.048). When Wells score is added with analysis a significant correlation was also found (80.6%, p = 0.044).

CONCLUSION: A significant correlation was found between increased D-Dimer levels positive Doppler ultrasound results (79.4%, p = 0.048). When Wells score is added with analysis a significant correlation was also found (80.6%, p = 0.044).



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