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D-Dimer Tests in the Emergency Department: Current Insights
Francesca Innocenti1, Cristian Lazzari1, Francesca Ricci1
1Emergency Department High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Florence, Italy.
Open Access Emergency Medicine : OAEM
|November 19, 2021
Summary
D-dimer testing is useful for diagnosing venous thromboembolism and aortic syndrome in emergency medicine, particularly in patients with low to moderate probability. It also shows prognostic value in sepsis and COVID-19 patients.
Area of Science:
- Emergency Medicine
- Clinical Pathology
Background:
- D-dimer is used in emergency medicine for venous thromboembolism and aortic syndrome diagnosis.
- Nonspecific symptoms like chest pain necessitate broad differential diagnoses.
- D-dimer's utility depends on pre-test probability, avoiding overtesting.
Purpose of the Study:
- To review the role of D-dimer in diagnosing venous thromboembolism and aortic syndrome.
- To explore the prognostic value of D-dimer in septic patients.
- To assess D-dimer's relevance in SARS-CoV-2 (COVID-19) patients.
Main Methods:
- Narrative review of existing literature.
- Analysis of D-dimer's diagnostic utility based on pre-test probability.
- Examination of D-dimer's prognostic implications in critical illnesses.
Main Results:
- D-dimer is most beneficial in patients with low to moderate pre-test probability for venous thromboembolism/aortic syndrome.
- High pre-test probability renders D-dimer results futile.
- Low specificity can lead to overtesting in very low probability cases.
- D-dimer may aid in early prognostic stratification of septic and severe COVID-19 patients.
Conclusions:
- D-dimer testing should be guided by pre-test probability to optimize diagnostic yield and avoid unnecessary imaging.
- Further research is needed to clarify D-dimer's role in managing severe COVID-19.
- D-dimer shows potential as a prognostic marker in critical care settings.
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