D-dimer: Difference between revisions

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==Differential Diagnosis==
*'''Factors that can cause false-negative D-dimer'''
*'''Factors that can cause false-negative D-dimer'''
**Symptoms of PE > 3 days
**Symptoms of [[PE]] > 3 days
**Small PE
**Small [[PE]]
**Use of qualitative latex fixation test
**Use of qualitative latex fixation test
**Use of anticoagulants
**Use of [[anticoagulants]]
*'''Factors that can cause false-positive D-dimer'''
*'''Factors that can cause false-positive D-dimer'''
**Cancer and malignancy
**Cancer and malignancy
**Recent surgery
**Recent surgery
**Infection (eg, PNA, sepsis)
**Infection (eg, [[pneumonia]], [[sepsis]])
**Pregnancy
**[[Pregnancy]]
**Age > 70 years
**Age > 70 years
**DIC
**[[DIC]]
**Trauma
**[[Trauma]]
**Arterial thrombosis
**[[Arterial thrombosis]]
**ACS/AMI
**[[ACS]]/AMI
**Vaso-occlusive sickle cell crisis
**Vaso-occlusive [[sickle cell crisis]]
**Acute CVA
**Acute [[CVA]]
**Vasculitis
**[[Vasculitis]]
**Superficial phlebitis
**Superficial [[phlebitis]]
 
==Evaluation==
*Traditional cutoff value = 500
*Age-adjusted (for over 50 years old) = age x 10
**Maintains high sensitivity while increasing specificity<ref>Sharp AL, et al. An Age-Adjusted D-dimer Threshold for Emergency Department Patients with Suspected Pulmonary Embolus: Accuracy and Clinical Implications. Feb 2016. Annals of EM. 67(2);249-257.</ref>
*YEARS<ref>MDCalc YEARS https://www.mdcalc.com/years-algorithm-pulmonary-embolism-pe</ref> and PEGeD<ref>Anand Swaminathan, "PEGeD Study – Is It Safe to Adjust the D-Dimer Threshold for Clinical Probability?", REBEL EM blog, December 16, 2019. Available at: https://rebelem.com/peged-study-is-it-safe-to-adjust-the-d-dimer-threshold-for-clinical-probability/</ref> adjust cut off base on clinical probability still being studied.
 
==See Also==
==See Also==
*[[Pulmonary Embolism (PE)]]
*[[Age adjusted D-dimer]]
*[[Pulmonary embolism]]
*[[Deep venous thrombosis]]
*[[Pulmonary_embolism_in_pregnancy#D-Dimer|D-dimer for pulmonary embolism in pregnancy]]
 
==External Links==
*[http://www.ncbi.nlm.nih.gov/pubmed/22284935 D-dimer threshold increase. Kline et. al.]
*[http://pemplaybook.org/podcast/big-labs-little-people-troponin-bnp-d-dimer-and-lactate/ Pediatric Emergency Playbook Podcast: Big Labs, Little People]


==References==
==References==
*[http://www.ncbi.nlm.nih.gov/pubmed/22284935 D-dimer threshold increase. Kline et. al.]
<references/>


[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Pulmonary]]
[[Category:Pulmonary]]
[[Category:Vascular]]
[[Category:Vascular]]

Revision as of 16:15, 18 December 2019

Differential Diagnosis

Evaluation

  • Traditional cutoff value = 500
  • Age-adjusted (for over 50 years old) = age x 10
    • Maintains high sensitivity while increasing specificity[1]
  • YEARS[2] and PEGeD[3] adjust cut off base on clinical probability still being studied.

See Also

External Links

References

  1. Sharp AL, et al. An Age-Adjusted D-dimer Threshold for Emergency Department Patients with Suspected Pulmonary Embolus: Accuracy and Clinical Implications. Feb 2016. Annals of EM. 67(2);249-257.
  2. MDCalc YEARS https://www.mdcalc.com/years-algorithm-pulmonary-embolism-pe
  3. Anand Swaminathan, "PEGeD Study – Is It Safe to Adjust the D-Dimer Threshold for Clinical Probability?", REBEL EM blog, December 16, 2019. Available at: https://rebelem.com/peged-study-is-it-safe-to-adjust-the-d-dimer-threshold-for-clinical-probability/