Appropriate use of D-dimer in hospital patients.

D-dimer, the final product of plasmin-mediated degradation of fibrin-rich thrombi, has emerged as a simple blood test that can be used in diagnostic algorithms for the exclusion of venous thromboembolism. D-dimer also is used as a part of the diagnostic tests for disseminated intravascular coagulation, where excessive thrombin generation is the key pathophysiological factor. However, there are no robust data available at present on the use of this test to exclude venous thromboembolism in a hospital inpatient. Considerable confusion also exists among physicians about its appropriate use and interpretation in disseminated intravascular coagulation. This article focuses on the available evidence to guide the appropriate use of D-dimer in patients admitted to a hospital. Copyright 2010 Elsevier Inc. All rights reserved.