Tesis

Akurasi Hasil Pemeriksaan D-dimer atau Ultrasonografi untuk Deteksi Trombosis Vena Dalam pada Trauma Ekstremitas Bawah: Sebuah Tinjauan Sistematis = Accuracy of D-dimer or Ultrasonography Examination Results for Detecting Deep Vein Thrombosis in Lower Extremity Trauma: A Systematic Review.

Pendahuluan: Trombosis vena dalam atau deep vein thrombosis (DVT) dan emboli paru yang dikenal sebagai tromboemboli vena (TEV) adalah komplikasi yang sering terjadi pada pasien trauma. Namun, penggunaan venografi sebagai baku emas terbatasi oleh trauma ekstremitas bawah. Penelitian ini bertujuan untuk menilai nilai diagnosis USG atau D-dimer dibandingkan dengan venografi dalam diagnosis DVT. Metode : Peneliti melakukan penelusuran sistematis yang didaftarkan di PROSPERO secara daring menggunakan kata kunci (Lower limb OR Lower extremity) AND (Trauma OR Injury) AND (Deep Vein Thrombosis OR Venous Thrombosis) AND (Duplex Scanning OR Ultrasonography OR Ultrasound) AND (D dimer) AND (Venography or Contrast Venography or Phlebography) AND(Accuracy OR Sensitivity OR Specificty) pada basis data Cochrane, EBSCOhost, PubMed, dan ProQuest pada bulan Januari-Mei 2023. Hasil studi akan dilakukan telaah kritis menggunakan Diagnostics Critical Appraisal Sheet yang dikeluarkan oleh Oxford Centre for Evidence-Based Medicine dan dinilai risiko biasnya menggunakan QUADAS-2. Hasil : Penelusuran menemukan 3 studi yang terdiri atas 2 studi kohort prospektif, dan 1 studi potong lintang. Semua studi memiliki validitas tinggi dan risiko bias yang rendah. USG memiliki sensitivitas yang berkisar antara 18-96%, spesifisitas 86-95,5% dalam menegakan diagnosis DVT. D-dimer ditemukan memiliki sensitivitas 63,9-100% dan spesifisitas 44,83-96,6%. Kesimpulan : USG dan D-dimer dapat membantu dalam mendiagnosis DVT pasien yang mengalami trauma ekstremitas bawah.


Introduction: Deep vein thrombosis (DVT) and pulmonary embolism known as venous thromboembolism (TEV) are complications that often occur in trauma patients. However, the use of venography as the gold standard is limited by lower extremity trauma. This study aimed to assess the diagnostic value of ultrasound or D-dimer compared with venography in the diagnosis of DVT. Method: Researchers conducted a systematic search registered in PROSPERO online using the keywords (Lower limb OR Lower extremity) AND (Trauma OR Injury) AND (Deep Vein Thrombosis OR Venous Thrombosis) AND (Duplex Scanning OR Ultrasonography OR Ultrasound) AND (D dimer) AND (Venography or Contrast Venography or Phlebography) AND (Accuracy OR Sensitivity OR Specificity) on the Cochrane, EBSCOhost, PubMed, and ProQuest databases in January-May 2023. The study results will be critically reviewed using the Diagnostics Critical Appraisal Sheet issued by Oxford Center for Evidence-Based Medicine and assessed risk of bias using QUADAS-2. Results: The search found 3 studies consisting of 2 prospective cohort studies and 1 cross-sectional study. All studies had high validity and low risk of bias. Ultrasound has a sensitivity ranging from 18-96%, specificity 86-95.5% in confirming the diagnosis of DVT. D-dimer was found to have a sensitivity of 63.9- 100% and a specificity of 44.83-96.6%. Conclusion : Ultrasound and D-dimer can be helpful in diagnosing DVT in patients who have experienced lower extremity trauma.