To evaluate the incidence of deep vein thrombosis (DVT) after major hip surgery along with the efficacy of the D-dimer as a routine noninvasive-screening test for DVT.

From May 2003 to August 2004, 289 patients who underwent major hip surgery were evaluated prospectively. All the patients underwent B-mode ultrasonography (US) preoperatively, and venography or US on postoperative 7 to 10 days. The D-dimer level was also estimated preoperatively, and at 3 and 7 days after surgery.

The preoperative D-dimer level was an average 0.60 ug/ml. DVT was encountered in 29 patients (10.1%) and in 28.9% of those over 60 years of age (p<0.05). Three days after surgery, the average D-dimer level was 3.82 ug/ml in the DVT positive patients and 2.26 ug/ml in the DVT negative patients. Seven days after surgery, the average D-dimer level in the DVT positive and negative patients was 5.19 ug/ml and 2.89 ug/ml. The most predictable D-dimer level for DVT 3 and 7 days after surgery were 2.585 ug/ml and 3.625 ug/ml, respectively.

The overall incidence of DVT in our patients undergoing major hip surgery seemed lower than in Western populations. However, there was a significantly increasing tendency if the development of DVT in the older age group. We also recommend a D-dimer assay at postoperative 7 days as a valuable screening test for detection of DVT.