The Usefulness of the Combination of D-Dimer and Soluble Fibrin Monomer Complex for Diagnosis of Venous Thromboembolism in Psychiatric Practice: A Prospective Study

Figures & data

Figure 1 Selection of participants. During the research period, 783 subjects were admitted to our hospital for the treatment of psychiatric disorders. Of these, 109 subjects without venous thromboembolism (VTE) symptoms participated in the study, and 47 subjects showed positive test results (D-Dimer ≥1). SFMC was not measured in four subjects. Two patients were withdrawn from the study after the VTE screening. Finally, 41 subjects underwent contrast computerized tomography.

Abbreviations: SFMC, soluble fibrin monomer complex; VTE, venous thromboembolism.

Table 1 Clinical and Demographic Characteristics

	VTE-Positive (n=17)	VTE-Negative (n=24)	p-value
D-dimer (µg/mL)^†	4.43 (2.56–8.36)	1.71 (1.41–2.61)	p=0.000*
SFMC (µg/mL)^†	10.6 (5.7–34.5)	3.5 (2.3–6.2)	p=0.000*
Age, yr^†	67 (58–78)	68.5 (56.25–76.5)	p=0.863
Sex^‡			p=0.745
Male	7	8
Female	10	16
BMI (kg/m^2)^†	21.2 (18.8–24.3)	20.0 (19.2–23.65)	p=0.853
Psychiatric disorders (ICD-10)
F0	1	6
F1	0	1
F2	2	2
F3	14	15
Restraint^‡	4	7	p=0.736
Catatonia^‡	2	1	p=0.560
Antidepressants^‡	10	12	p=0.752
IMPE^†	100 (0–188)	18.8 (0–100)	p=0.301
CPZE^†	0 (0–250)	100 (0–302)	p=0.354
Surgery <4 w^‡	0	0	Not calculated
Trauma <4 w^‡	1	1	p=1.000
Active cancer^‡	3	2	p=0.633
Infection^‡	0	2	p=0.502
DIC^‡	0	0	Not calculated
History of VTE^‡	1	1	p=1.000
Anticoagulants^‡	1	1	p=1.000
HT^‡	7	10	p=1.000
HL^‡	3	7	p=0.480
DM^‡	2	4	p=1.000
Fever (°C)^†	36.7 (36.3–36.8)	36.7 (36.4–36.9)	p=0.894

Notes: Values are presented as medians (25–75% percentile). Significant p-values are labeled with an asterisk. ^†Mann–Whitney U-test; ^‡Fisher’s exact test.

Abbreviations: BMI, body mass index; CPZE, chlorpromazine equivalents; DM, diabetes mellitus; ICD-10, International Classification of Diseases 10th Revision; IMPE, imipramine equivalents; HL, hyperlipidemia; HT, hypertension; SFMC, soluble fibrin monomer complex; VTE, venous thromboembolism.

Figure 2 D-dimer and SFMC values in VTE-positive and VTE-negative patients. Bee swarm diagram showing the distribution of venous thromboembolism (VTE)-positive and VTE-negative patients for respective D-dimer and soluble fibrin monomer complex values.

Abbreviation: VTE, venous thromboembolism.

Figure 3 Receiver-operator characteristic curve (ROC) for predicting the possibility of venous thromboembolism based on soluble fibrin monomer complex (SFMC) values. The area under the curve was 0.848 for SFMC (95% CI 0.722 to 0.974, p<0.001).