BACKGROUND: The diagnosis of pulmonary embolism is difficult because the clinical diagnosis is nonspecific and all of the objective tests have limitations. The assay for plasma d-dimer may be useful as an exclusion test if results are negative. We conducted a prospective cohort study that evaluated the clinical utility (usefulness) of an automated quantitative d-dimer test in the diagnosis of patients with suspected pulmonary embolism. METHODS: Consecutive eligible patients who had clinically suspected PE with nondiagnostic lung scans or negative helical CT scan of the chest results underwent d-dimer testing. RESULTS: The d-dimer results were negative in 11 of 103 inpatients (10.6%, 95% confidence interval [CI], 5.5 to 18.3%) and 7 of 22 outpatients (31.8%, 95% CI, 13.9 to 54.9%; p = 0.02). CONCLUSIONS: Measurement of plasma d-dimer is of limited clinical utility for inpatients with clinically suspected pulmonary embolism and nondiagnostic lung scans or negative helical CT results at a US academic health center.
BACKGROUND: The diagnosis of pulmonary embolism is difficult because the clinical diagnosis is nonspecific and all of the objective tests have limitations. The assay for plasma d-dimer may be useful as an exclusion test if results are negative. We conducted a prospective cohort study that evaluated the clinical utility (usefulness) of an automated quantitative d-dimer test in the diagnosis of patients with suspected pulmonary embolism. METHODS: Consecutive eligible patients who had clinically suspected PE with nondiagnostic lung scans or negative helical CT scan of the chest results underwent d-dimer testing. RESULTS: The d-dimer results were negative in 11 of 103 inpatients (10.6%, 95% confidence interval [CI], 5.5 to 18.3%) and 7 of 22 outpatients (31.8%, 95% CI, 13.9 to 54.9%; p = 0.02). CONCLUSIONS: Measurement of plasma d-dimer is of limited clinical utility for inpatients with clinically suspected pulmonary embolism and nondiagnostic lung scans or negative helical CT results at a US academic health center.
Authors: J S Ginsberg; P S Wells; C Kearon; D Anderson; M Crowther; J I Weitz; J Bormanis; P Brill-Edwards; A G Turpie; B MacKinnon; M Gent; J Hirsh Journal: Ann Intern Med Date: 1998-12-15 Impact factor: 25.391
Authors: M J Kovacs; K M MacKinnon; D Anderson; K O'Rourke; M Keeney; C Kearon; J Ginsberg; P S Wells Journal: Br J Haematol Date: 2001-10 Impact factor: 6.998
Authors: M Miniati; R Prediletto; B Formichi; C Marini; G Di Ricco; L Tonelli; G Allescia; M Pistolesi Journal: Am J Respir Crit Care Med Date: 1999-03 Impact factor: 21.405
Authors: A Perrier; N Howarth; D Didier; P Loubeyre; P F Unger; P de Moerloose; D Slosman; A Junod; H Bounameaux Journal: Ann Intern Med Date: 2001-07-17 Impact factor: 25.391
Authors: A Perrier; S Desmarais; M J Miron; P de Moerloose; R Lepage; D Slosman; D Didier; P F Unger; J V Patenaude; H Bounameaux Journal: Lancet Date: 1999-01-16 Impact factor: 79.321