Whole blood D-dimer assay: An effective noninvasive method to rule out pulmonary embolism

John T Owings, Robert C. Gosselin, Felix D. Battistella, John T Anderson, Michael Petrich, Edward C. Larkin

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Background: The whole blood D-dimer assay has gained recognition as a noninvasive test to rule out pulmonary embolism (PE) in medical patients. Methods: We performed a whole blood D-dimer assay in medical and surgical patients undergoing either pulmonary angiogram or pulmonary ventilation perfusion scan for suspected PE or duplex Doppler or venogram for suspected deep venous thrombosis (DVT). Results: A total of 483 patients were enrolled; 16 were excluded because of an equivocal pulmonary ventilation perfusion scan. The 467 remaining patients had a mean age of 56 ± 27 years. There were 258 women and 209 men. A total of 353 patients were admitted to a medical service and 114 to surgery/trauma. A total of 82 patients (18%) developed thromboembolism: 20 had PE, and 62 had DVT. Conclusion: No surgical patient with PE or DVT (n = 27) had a negative D-dimer. A negative D-dimer result in a stable surgical patient should be considered conclusive evidence to rule out thromboembolism and, thus, negate the need for further diagnostic studies. In our surgical patients suspected of DVT or PE, had D-dimer been used, one third of the patients would have avoided an expensive or invasive diagnostic test.

Original languageEnglish (US)
Pages (from-to)795-800
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume48
Issue number5
StatePublished - May 2000

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Keywords

  • D-dimer
  • Deep venous thrombosis
  • Pulmonary embolism
  • Surgery
  • Trauma

ASJC Scopus subject areas

  • Surgery

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