[Does D-dimer determination allow the exclusion of pulmonary embolism?]

Abstract

The presence of D-dimers in the serum reflects fibrin formation and lysis. If the serum D-dimer level is lower than a threshold level which depends on the assay technique (usually 500 micrograms/l), pulmonary embolism can be excluded with a predictive value of 95%. This makes D-dimer assay an ideal screening tool for ambulatory patients with suspected pulmonary embolism. Screening costs can be reduced in about one-third of the cases as other tests are not required. For routine practice, only ELISA tests have been validated for this indication, the sensitivity of latex tests being too low. D-dimer assay would be of little benefit for patients hospitalized for more than 24 for reasons other than suspected pulmonary embolism as specificity is very low in this population.