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D-dimer as a stand-alone test to rule out deep vein thrombosis

Permanent lenke
https://hdl.handle.net/10037/20889
DOI
https://doi.org/10.1016/j.thromres.2020.04.026
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article.pdf (323.5Kb)
(PDF)
Dato
2020-04-25
Type
Journal article
Tidsskriftartikkel

Forfatter
Rinde, Fridtjof Balteskard; Frønæs, Synne Grønvold; Ghanima, Waleed Khalid; Vik, Anders; Hansen, John-Bjarne; Brækkan, Sigrid
Sammendrag
Background - Current guidelines recommend the use of clinical decision rules, such as Wells score, in combination with D-dimer to assess the need for objective imaging to rule out deep vein thrombosis (DVT). However, the clinical decision rule has limitations, and use of D-dimer as a stand-alone test has been suggested.

Objective - We aimed to assess the safety and efficiency of D-dimer as a stand-alone test to rule out DVT in outpatients referred with suspected DVT.

Methods - We collected data from consecutive outpatients referred to our hospital with suspected DVT in 2008–2018. D-dimer levels were analyzed using STA® Liatest® D-Di assay. D-dimer as a stand-alone test was theoretically applied in retrospect, and the number of misdiagnosed events were estimated as if such an approach had been initially used. All patients were followed for three months.

Results - Of 1765 included patients, 293 (16.6%) were diagnosed with DVT. A total of 491 patients (27.8%) had a negative D-dimer (<500 ng/mL). Of these, nine were diagnosed with DVT, yielding a failure rate for D-dimer as a stand-alone test of 1.8% (95% CI 0.8%–3.5%). The majority of the misdiagnosed patients had distal DVT. In analyses restricted to proximal DVTs, the failure rate was 0.6% (95% CI 0.1%–1.8%). D-dimer as a stand-alone approach reduced the proportion of required ultrasounds from 81.8% to 72.2%.

Conclusion - D-dimer as a stand-alone test may be safe for excluding proximal DVT and reduce the proportion of required ultrasounds. Prospective management studies are needed to confirm our findings.

Beskrivelse
Submitted manuscript version
Er en del av
Rinde, F.B. (2023). D-dimer for diagnosis and risk assessment of first and recurrent venous thromboembolism. (Doctoral thesis). https://hdl.handle.net/10037/29270.
Forlag
Elsevier
Sitering
Rinde, Frønæs, Ghanima, Vik, Hansen, Brækkan. D-dimer as a stand-alone test to rule out deep vein thrombosis. Thrombosis Research. 2020;191:134-139
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  • Artikler, rapporter og annet (klinisk medisin) [1974]
Copyright 2020 The Author(s)

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