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Fig. 1

Receiver operating characteristic (ROC) curve for admission D-dimer and D-dimer/fibrinogen ratio for the diagnosis of clinically suspected and confirmed venous thromboembolism
Receiver operating characteristic (ROC) curve for admission D-dimer and D-dimer/fibrinogen ratio for the diagnosis of clinically suspected and confirmed venous thromboembolism

Characteristics of patients

All patients N=310 VTE N=41 No VTE N=269 P value
Age (years), mean±SD 60.1±15.1 58.8±15.7 60.3±15.1 0.56
Male gender, N (%) 233 (75.2) 30 (73.2) 203 (75.5) 0.75

Body mass index* (kg/m2), median (Q1, Q3) 28.9 (25.0, 34.1) 27.1 (24.4, 33.3) 29.1 (25.1, 34.2) 0.32
No obesity < 30 kg/m2, N (%) 169 (55.6) 25 (62.5) 144 (54.5)
Obesity 30-39.9 kg/m2, N (%) 110 (36.2) 10 (25.0) 100 (37.9) 0.22
Obesity ≥ 40 kg/m2, N (%) 25 (8.2) 5 (12.5) 20 (7.6)

Comorbid conditions, N (%)
Hypertension 173 (56.0) 22 (53.7) 151 (56.3) 0.75
Diabetes 173 (56.0) 22 (53.7) 151 (56.3) 0.75
Congestive heart failure 22 (7.1) 1 (2.4) 21 (7.8) 0.21
COPD 10 (3.2) 0 (0) 10 (3.7) 0.21
Bronchial asthma 18 (5.8) 6 (14.6) 12 (4.5) 0.02
Chronic kidney disease 36 (11.7) 3 (7.3) 33 (12.3) 0.35
Hemodialysis 11 (3.6) 11 (3.6) 9 (3.4) 0.63
Previous VTE, N (%) 11 (3.5) 1 (2.4) 10 (3.7) 1.0
History of thrombophilia 9 (2.9) 1 (2.4) 8 (3.0) 1.0
Prior anticoagulation 20 (6.5) 2 (4.9) 18 (6.7) 1.0
GCS on admission, mean±SD 12.3±4.5 11.5±4.9 12.5±4.4 0.21
SOFA on admission, mean±SD 6.1±3.9 6.5±3.9 6.0±3.9 0.52
SOFA at day 7, mean±SD 6.8±4.3 7.2±3.6 6.7±4.4 0.45

Pertinent laboratory findings on admission
Creatinine (μmol/L), median (Q1, Q3) 93.0 (73.0, 144.5) 103.0 (71.5, 139.5) 93.0 (73.0, 146.8) 0.97
WBC x 109/L, median (Q1, Q3) 9.82 (6.65, 13.80) 10.80 (7.37, 16.10) 9.81 (6.51, 13.75) 0.22
Neutrophils 7.94 (4.95, 11.55) 7.82 (5.45, 11.70) 7.95 (4.88, 11.54) 0.51
Lymphocytes 0.93 (0.63, 1.41) 0.89 (0.62, 1.32) 0.94 (0.64, 1.42) 0.54
Admission hemoglobin (g/L), mean±SD 129±24 132±25 128±24 0.37
Admission platelets x 109/L, mean±SD 279±120 291±137 278±117 0.51
PTT in seconds, median (Q1, Q3) 29.1 (26.5, 32.6) 28.5 (26.0, 32.8) 29.3 (26.5, 32.6) 0.61
INR, median (Q1, Q3) 1.10 (1.04, 1.18) 1.12 (1.06, 1.30) 1.10 (1.03, 1.18) 0.12
Lactate (mmol/L), mean±SD 2.6±2.4 3.1±3.2 2.5±2.3 0.31
Lactate dehydrogenase (U/L), median (Q1, Q3) 553.0 (430.0, 749.0) 615.0 (412.0, 837.0) 544.5 (437.5, 731.5) 0.23
Fibrinogen (g/L), median (Q1, Q3) 5.22 (3.81, 6.92) 4.05 (2.62, 6.07) 5.49 (3.97, 7.06) 0.003
D-Dimer (mg/L), median (Q1, Q3) 1.70 (0.80, 4.05) 3.86 (1.28, 14.43) 1.47 (0.77, 3.72) 0.001
D-Dimer/fibrinogen ratio 1.9±5.3 4.2±8.7 1.5±4.5 0.14

Key interventions in the ICU before VTE
Central venous catheter 206 (66.5) 33 (80.5) 173 (64.3) 0.04
Internal jugular 156 (50.3) 26 (63.4) 130 (48.3)
Subclavian 13 (4.2) 3 (7.3) 10 (3.7) 0.20
Femoral 34 (11.0) 4 (9.8) 30 (11.2)
Vasopressor use, N (%) 138 (44.7) 27 (67.5) 111 (41.3) 0.002
Invasive mechanical ventilation, N (%) 208 (67.1) 33 (80.5) 175 (65.1) 0.05
PaO2/FiO2 ratio before intubation, median (Q1, Q3) 92.5 (66.5, 164.3) 90.0 (78.7, 214.5) 95.8 (63.0, 153.0) 0.17
Renal replacement therapy, N (%) 67 (21.6) 11 (26.8) 56 (20.8) 0.38

VTE prophylaxis practices

Variables All patients N=310 VTE N=41 No VTE N=269 P value
No anticoagulant prophylaxis, N (%)
9 (2.9)
3 (7.3)
6 (2.2)
0.10
UFH, N (%) 115 (37.1) 15 (36.6) 100 (37.2) 0.94
Standard dose (5000 U 12 hrly) 53 (46.1)* 8 (53.3)* 45 (45.0)* 0.59
standard dose (5000 U 8 hrly) 53 (46.1)* 4 (26.7)* 49 (49.0)* 0.16
Intravenous infusion
9 (7.8)*
3 (20.0)*
6 (6.0)*
0.09
LMWH, N (%) 185 (59.7) 23 (56.1) 162 (60.2) 0.62
standard dose* 104 (56.2)* 11 (47.8)* 93 (57.4)* 0.50
Intermediate dose*¶ 57 (30.8)* 3 (13.0)* 54 (33.3)* 0.055
Therapeutic dose* 24 (13.0)* 9 (39.1)* 15 (9.3)* <0.001

Outcomes of patients in the cohort

Variables All patients N=310 VTE N=41 No VTE N=269 P value
Major bleeding, N (%)
42 (13.5)
8 (19.5)
34 (12.6)
0.23
Tracheostomy, N (%)
29 (9.4)
9 (22.0)
20 (7.4)
0.003
Duration of invasive MV (days), median (Q1, Q3)
12.0 (7.0, 20.0)
12.00 (7.0, 30.5)
12.0 (7.0, 19.0)
0.36
ICU LOS (days), median (Q1, Q3)
All patients 10.0 (5.0, 18.0) 13.0 (7.0, 25.5) 10.0 (4.5, 17.0) 0.04
Patients who received invasive MV
14.0 (9.0, 22.0)
16.0 (9.5, 33.0)
14.0 (9.0, 21.0)
0.39
Hospital LOS (days), median (Q1, Q3)
19.0 (12.0, 29.0)
30.0 (19.0, 42.0)
17.0 (12.0, 27.0)
<0.001
ICU Mortality, N (%) 123 (39.8) 12 (29.3) 111 (41.4) 0.14
Hospital mortality, N (%) 147 (47.4) 13 (31.7) 134 (49.8) 0.03
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