[Does D-dimer determination allow the exclusion of pulmonary embolism?].
The presence of D-dimers in the serum reflects fibrin formation and lysis. If the serum D-dimer level is lower than a threshold level which depends on the assay technique (usually 500 micrograms/l), pulmonary embolism can be excluded with a predictive value of 95%. This makes D-dimer assay an ideal screening tool for ambulatory patients with suspected pulmonary embolism. Screening costs can be reduced in about one-third of the cases as other tests are not required. For routine practice, only ELISA tests have been validated for this indication, the sensitivity of latex tests being too low. D-dimer assay would be of little benefit for patients hospitalized for more than 24 for reasons other than suspected pulmonary embolism as specificity is very low in this population.
Division d'Angiologie et d'Hémostase, Hôpitaux Universitaires de Genève, Suisse.
H
H
Bounameaux
D000553:Ambulatory Care; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006760:Hospitalization; D006801:Humans; D011655:Pulmonary Embolism / Q000097:blood* / Q000175:diagnosis*
D005338:Fibrin Fibrinogen Degradation Products
Le dosage des D-dimères permet-il d'exclure une embolie pulmonaire?