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. 2012:2012:517375.
doi: 10.1155/2012/517375. Epub 2012 Jul 24.

Shifting up cutoff value of d-dimer in the evaluation of pulmonary embolism: a viable option? Possible risks and benefits

Bennidor Raviv  1 , Shlomo H Israelit
Affiliations

Shifting up cutoff value of d-dimer in the evaluation of pulmonary embolism: a viable option? Possible risks and benefits

Bennidor Raviv et al. Emerg Med Int. 2012.

Abstract

Objectives. To evaluate the viability of the possibility to use a higher D-dimer value than the one used today in the clinical algorithms evaluating patients suspected to have pulmonary embolism. Methods. A retrospective analysis of 300 serial patients for whom D-dimer values were taken during a 10 month period in the emergency room of a tertiary medical center. Results. Our analysis showed that it may be safe and cost effective to use a D-dimer value of 900 ng/ml rather than the value of 500 ng/ml accepted today, with sensitivity of 94.4%. In younger patients [under 40 years] the sensitivity reached was even higher-100%. Conclusions. Raising cutoff values of D-dimer in screening for pulmonary embolism seems a viable option. There may be a place for "tailoring" cutoff values according individual patient characteristics, such as according age groups. More studies of the subject are warranted.

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Figures

Figure 1
Figure 1
An ROC curve depicting the data. The area under the curve equal 0.835 with 95% Confidence interval 0.72–0.949.
See this image and copyright information in PMC

References

    1. Fesmire FM, Brown MD, Espinosa JA, et al. Critical issues in the evaluation and management of adult patients presenting to the emergency department with suspected pulmonary embolism. American College of emergency physicians clinical policies subcommittee on critical issues in the evaluation and management of adult patients presenting to the EMERGENCY DEPARTMENT with suspected pulmonary embolism. Annals of Emergency Medicine. 2011;57(6):628–652e75. - PubMed
    1. Haro LH, Decker WW, Boie ET, Wright RS. Initial approach to the patient who has chest pain. Cardiology Clinics. 2006;24(1):1–17. - PubMed
    1. Goldhaber SZ. Harrison’s Principles of Internal Medicine. 17th edition. McGraw–Hill; 2008. Deep venous thrombosis and pulmonary thromboembolism.
    1. Wells PS, Anderson DR, Rodger M, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thrombosis and Haemostasis. 2000;83(3):416–420. - PubMed
    1. Kelly J, Rudd A, Lewis RR, Hunt BJ. Plasma D-dimers in the diagnosis of venous thromboembolism. Archives of Internal Medicine. 2002;162(7):747–756. - PubMed

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