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Published on: February 10, 2023
An elevated D-dimer value: a burden on our patients and hospitals
Nitin Chopra1, Pradeep Doddamreddy, Hermanjeet Grewal
1Jackson Park Hospital, Chicago, IL, USA.
International Journal of General Medicine
|February 10, 2012
Summary
Elevated D-dimer tests for pulmonary embolism (PE) are often inefficient and costly. A scoring system like the revised-Geneva scale can improve diagnostic accuracy and reduce unnecessary testing for PE.
Area of Science:
- Medical Diagnostics
- Cardiology
- Health Economics
Background:
- Pulmonary embolism (PE) causes significant mortality in the US.
- Current diagnostic strategies for PE, particularly relying on D-dimer, may be inefficient.
Purpose of the Study:
- To assess the diagnostic and financial yield of D-dimer testing in diagnosing PE.
- To evaluate the effectiveness of the current diagnostic approach for PE.
Main Methods:
- Retrospective review of 220 patient medical records at a South Chicago Community Hospital.
- Analysis of diagnostic work-ups following elevated D-dimer values for suspected PE.
- Inclusion of randomly selected patients with no exclusion criteria.
Main Results:
- Only 4.2% (5 out of 118) of patients with elevated D-dimer values were diagnosed with PE.
- Diagnostic tests ordered due to elevated D-dimer values incurred over $200,000 in billing.
- Age and African-American origin were identified as factors elevating D-dimer independent of PE.
Conclusions:
- The current diagnostic approach for PE based primarily on elevated D-dimer is medically and financially inefficient.
- Implementing scoring systems, such as the revised-Geneva scale, can enhance diagnostic suspicion and improve work-up yield.
- A refined diagnostic strategy is needed to optimize PE diagnosis and resource allocation.
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