D-dimer testing: advantages and limitation in emergency medicine for managing acute venous thromboembolism

Sergio Siragusa, Sergio Siragusa

Risultato della ricerca: Articlepeer review

20 Citazioni (Scopus)

Abstract

D-dimer values can be rapidly determined and used for themanagement of acute venous thromboembolism (VTE).However, its role in the setting of emergency still remainsunclear and inappropriate testing is a significant clinicalproblem. This review discusses the currently used assays,clinical indications, and limitations of D-dimer measurement.Studies in English language were identified by searchingPubMed from December 1985 to December 2005. Availableliterature on D-dimer was identified from Medline, along withcross referencing from the reference lists of major articles andreviews on this subject. Among 56 articles collected, 14 papers, 4 overviews and 1systemic review were selected accordingly to predefinedcriteria. Data synthesis shows that D-dimer testing hassufficient diagnostic accuracy for ruling out acute VTE if usedin combination with standardised clinical judgement. D-dimerseems to be also a useful tool for managing suspected VTEpatients in absence of immediate imaging. Attention should bepaid to exclude conditions that may affect the accuracy of thetest, such as concomitant disease, heparin administration andsymptom duration > 15 days. Although enzyme-linkedimmunosorbent assay determination has the highest accuracy,immunoturbidimetric assay seems the most suitable on anemergency basis because of its rapid performance. In conclusion, at present D-dimer testing can be safely used inthe management of acute VTE in emergency medicine.However, because of its heterogeneity related to the methodused and setting implemented, it is preferable to assess D-dimer accuracy before its implementation in managementstrategies for VTE
Lingua originaleEnglish
pagine (da-a)59-66
Numero di pagine8
RivistaInternal and Emergency Medicine
Volume1
Stato di pubblicazionePublished - 2006

All Science Journal Classification (ASJC) codes

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  • ???subjectarea.asjc.2700.2711???

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