Point-of-care D-dimer testing in emergency departments

Area of Science:

• Emergency Medicine
• Clinical Pathology
• Diagnostic Testing

Background:

• Emergency department (ED) overcrowding and prolonged patient stays negatively impact patient experience, outcomes, and healthcare costs.
• Point-of-care testing (POCT) offers rapid laboratory results near the patient, addressing ED workflow challenges.
• D-dimer testing is crucial for excluding venous thromboembolism (VTE) in low-risk emergency department patients.

Purpose of the Study:

• To review the benefits of point-of-care D-dimer testing in emergency departments and urgent care settings.
• To evaluate the impact of POCT D-dimer on patient turnaround times, diagnosis, discharge, and referral.
• To assess the organizational benefits, including reduced ED crowding and improved cost-effectiveness.

Main Methods:

• Literature review of studies on point-of-care D-dimer testing in emergency and urgent care settings.
• Analysis of data on turnaround times (time to results, diagnosis, discharge, referral).
• Examination of evidence regarding ED crowding and cost-effectiveness.

Main Results:

• Point-of-care D-dimer testing significantly reduces turnaround times for results, diagnosis, and patient disposition.
• Implementation of POCT D-dimer contributes to decreased emergency department crowding.
• The use of POCT D-dimer, alongside pre-test probability scores, is cost-effective.

Conclusions:

• Point-of-care D-dimer testing is a safe and efficient method for ruling out VTE in low-risk patients presenting to emergency departments.
• POCT D-dimer improves the patient experience by expediting diagnosis and disposition.
• Integrating POCT D-dimer testing can optimize emergency department operations and resource utilization.