Factors Associated With Positive D-dimer Results in Patients Evaluated for Pulmonary Embolism

Autor: Carlos A. Camargo, Michael C. Plewa, Christopher L. Moore, Daren M. Beam, Peter B. Richman, D. Mark Courtney, Kristen E. Nordenholz, Howard A. Smithline, Christopher Kabrhel, Jeffrey A. Kline
Rok vydání: 2010
Předmět:
Zdroj: Academic Emergency Medicine. 17:589-597
ISSN: 1553-2712
1069-6563
DOI: 10.1111/j.1553-2712.2010.00765.x
Popis: Plasma D-dimer measurement is commonly used as the first test in patients suspected of having acute pulmonary embolism (PE). D-dimer testing is noninvasive and rapid, so it is not surprising that the availability of these tests can increase the number of patients evaluated for possible PE.1 However, low specificity limits the usefulness of D-dimer testing. Specificity is typically between 40% and 60%, leading to a high rate of false-positive results.2 Several factors, other than PE or deep vein thrombosis (DVT), are associated with positive D-dimer results. Some, such as advanced age, malignancy, and pregnancy, have been described in the medical literature.3–9 However, most prior studies have evaluated D-dimer testing in a select population of patients with a particular risk factor, rather than in an undifferentiated population of patients evaluated for PE.10–12 As a result, the ability to adjust results for the large variety of conditions that may elevate the D-dimer has been limited. In addition, risk factors have generally been studied as broad categories (e.g., recent surgery, history of cancer), but whether the described effects are consistent across more detailed subcategories (e.g., type of surgery, active vs. inactive malignancy) is not well known. We used data obtained from a large multicenter study of emergency department (ED) patients evaluated for PE to identify factors associated with a positive D-dimer result and quantify the effect of each factor in a multivariable analysis.
Databáze: OpenAIRE
Externí odkaz: