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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Does an immunochromatographic D-dimer exclude acute lower limb deep venous thrombosis?
Rathan M Subramaniam1, Rebekah Heath, Kim Cox
1Department of Radiology, Waikato Hospital, Auckland, New Zealand. rathan67@hotmail.com
Emergency Medicine Australasia : EMA
|November 7, 2006
Summary
An unlikely Hamilton Score combined with a negative D-dimer test reliably rules out deep venous thrombosis (DVT). This approach can reduce the need for ultrasound examinations in diagnosing DVT.
Area of Science:
- Medical Diagnostics
- Vascular Medicine
- Clinical Pathology
Background:
- Deep venous thrombosis (DVT) diagnosis often relies on ultrasound.
- Pre-test probability scores and D-dimer assays can potentially reduce unnecessary ultrasound use.
Purpose of the Study:
- To evaluate the accuracy of the 'Simplify' immunochromatographic D-dimer assay for diagnosing acute DVT.
- To assess the assay's performance in conjunction with the Hamilton Score.
Main Methods:
- Prospective recruitment of 453 patients with suspected DVT.
- All patients underwent Hamilton Score assessment, D-dimer testing, and lower limb ultrasound.
- Follow-up for 3 months for patients with negative ultrasound results.
Main Results:
- The D-dimer assay showed a negative predictive value of 94.3% for DVT.
- In patients with an unlikely Hamilton Score and negative D-dimer, the negative predictive value was 98.8%.
- This combination reliably excluded both proximal and isolated calf DVT.
Conclusions:
- An unlikely Hamilton Score and a negative immunochromatographic D-dimer test are effective in excluding DVT.
- This diagnostic strategy can safely reduce the need for ultrasound in suspected DVT cases.
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