Tags

Type your tag names separated by a space and hit enter

Exclusion of venous thromboembolism: evaluation of D-Dimer PLUS for the quantitative determination of D-dimer.
Thromb Res. 2005; 115(5):381-6.TR

Abstract

The objective of this study was to evaluate if D-Dimer PLUS (Dade Behring, USA), a rapid fully automated assay, could be used as an initial screening test in the diagnosis of venous thromboembolism (VTE). Samples from 274 consecutive symptomatic patients with suspected pulmonary embolism (n=229; 79% outpatients, 21% inpatients), deep venous thrombosis (n=37; 84% outpatients, 16% inpatients) or suspected for both complications (n=8) were tested with this D-dimer assay with a Sysmex CA-1500 Coagulation Analyzer. Clinical probability for pulmonary embolism (PE) or deep venous thrombosis (DVT) was staged according to a pretest risk score proposed by Wells. Final diagnosis of PE and/or DVT was established by spiral-computed tomography of the pulmonary arteries or compression ultrasonography, respectively. PE was diagnosed in 13.5% of the patients, whereas DVT was confirmed in 17.7% of the patients. The optimal cut-off value for exclusion of venous thromboembolism was 130 mug/l, and sensitivity, specificity and negative predictive value (NPV) were 95.0% (95% CI: 92.4-97.6), 30.4% (95% CI: 25.0-35.8) and 97.2% (95% CI: 95.2-99.2), respectively. In fact, two patient with PE were missed using D-Dimer PLUS; both cases were outpatients. In conclusion, this assay appears to be safe when implemented in an algorithm based on clinical assessment, D-dimer concentration, and radiological diagnostic techniques to stratify the risk for PE or DVT. However, higher sensitivities and negative predictive values were claimed in the scarce published reports for the D-Dimer PLUS assay than found in this study.

Authors+Show Affiliations

Department of Haematology, The Hague, The Netherlands. h.vermeer@leyenburg-ziekenhuis.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15733971

Citation

Vermeer, H J., et al. "Exclusion of Venous Thromboembolism: Evaluation of D-Dimer PLUS for the Quantitative Determination of D-dimer." Thrombosis Research, vol. 115, no. 5, 2005, pp. 381-6.
Vermeer HJ, Ypma P, van Strijen MJ, et al. Exclusion of venous thromboembolism: evaluation of D-Dimer PLUS for the quantitative determination of D-dimer. Thromb Res. 2005;115(5):381-6.
Vermeer, H. J., Ypma, P., van Strijen, M. J., Muradin, A. A., Hudig, F., Jansen, R. W., Wijermans, P. W., & Gerrits, W. B. (2005). Exclusion of venous thromboembolism: evaluation of D-Dimer PLUS for the quantitative determination of D-dimer. Thrombosis Research, 115(5), 381-6.
Vermeer HJ, et al. Exclusion of Venous Thromboembolism: Evaluation of D-Dimer PLUS for the Quantitative Determination of D-dimer. Thromb Res. 2005;115(5):381-6. PubMed PMID: 15733971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exclusion of venous thromboembolism: evaluation of D-Dimer PLUS for the quantitative determination of D-dimer. AU - Vermeer,H J, AU - Ypma,P, AU - van Strijen,M J L, AU - Muradin,A A, AU - Hudig,F, AU - Jansen,R W, AU - Wijermans,P W, AU - Gerrits,W B J, PY - 2004/07/05/received PY - 2004/08/20/revised PY - 2004/09/09/accepted PY - 2005/3/1/pubmed PY - 2005/9/15/medline PY - 2005/3/1/entrez SP - 381 EP - 6 JF - Thrombosis research JO - Thromb. Res. VL - 115 IS - 5 N2 - The objective of this study was to evaluate if D-Dimer PLUS (Dade Behring, USA), a rapid fully automated assay, could be used as an initial screening test in the diagnosis of venous thromboembolism (VTE). Samples from 274 consecutive symptomatic patients with suspected pulmonary embolism (n=229; 79% outpatients, 21% inpatients), deep venous thrombosis (n=37; 84% outpatients, 16% inpatients) or suspected for both complications (n=8) were tested with this D-dimer assay with a Sysmex CA-1500 Coagulation Analyzer. Clinical probability for pulmonary embolism (PE) or deep venous thrombosis (DVT) was staged according to a pretest risk score proposed by Wells. Final diagnosis of PE and/or DVT was established by spiral-computed tomography of the pulmonary arteries or compression ultrasonography, respectively. PE was diagnosed in 13.5% of the patients, whereas DVT was confirmed in 17.7% of the patients. The optimal cut-off value for exclusion of venous thromboembolism was 130 mug/l, and sensitivity, specificity and negative predictive value (NPV) were 95.0% (95% CI: 92.4-97.6), 30.4% (95% CI: 25.0-35.8) and 97.2% (95% CI: 95.2-99.2), respectively. In fact, two patient with PE were missed using D-Dimer PLUS; both cases were outpatients. In conclusion, this assay appears to be safe when implemented in an algorithm based on clinical assessment, D-dimer concentration, and radiological diagnostic techniques to stratify the risk for PE or DVT. However, higher sensitivities and negative predictive values were claimed in the scarce published reports for the D-Dimer PLUS assay than found in this study. SN - 0049-3848 UR - https://www.unboundmedicine.com/medline/citation/15733971/Exclusion_of_venous_thromboembolism:_evaluation_of_D_Dimer_PLUS_for_the_quantitative_determination_of_D_dimer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-3848(04)00496-7 DB - PRIME DP - Unbound Medicine ER -