D-dimer: Difference between revisions

 
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**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
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**[[DIC]]
**[[DIC]]
**[[Trauma]]
**[[Trauma]]
**Arterial thrombosis
**[[Arterial thrombosis]]
**[[ACS]]/AMI
**[[ACS]]/AMI
**Vaso-occlusive [[sickle cell crisis]]
**Vaso-occlusive [[sickle cell crisis]]
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==Evaluation==
==Evaluation==
*Traditional cutoff value = 500
*Traditional cutoff value = 500
*Age-adjusted (for over 50 years old) = age x 10
*Age-adjusted (for patients 50 years or older) = age x 10
**D-dimer less than OR equal to age x 10 makes VTE unlikely
**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>
**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==

Latest revision as of 17:24, 25 March 2021

Differential Diagnosis

Evaluation

  • Traditional cutoff value = 500
  • Age-adjusted (for patients 50 years or older) = age x 10
    • D-dimer less than OR equal to age x 10 makes VTE unlikely
    • 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/