Rapid ELISA D-dimer testing in the exclusion of venous thromboembolism in hospitalized patients.
The clinical diagnosis of deep-vein thrombosis (DVT) and pulmonary embolism (PE) is known to be unreliable. Until now, no biological marker has been found to confirm thrombosis, but help can be gained from a biological marker ruling out the diagnosis of DVT or PE, i.e., the sensitive measurement of D-dimer (DD) species. This article summarizes our experience in introducing a rapid D-dimer test (ELISA VIDAS D-dimères test, bioMérieux) in a collaborative strategy for thrombosis diagnosis during 9 consecutive months involving 1,131 measurements. The efficacy of the DD test was very different according the type of patient, and departments where the DD test provides a real diagnostic benefit were identified. High clinical probability for thrombosis was encountered in 32 patients and radiology was carried out, although D-dimer was negative: none of these patients was found to have a thrombosis after radiologic examination. However, extensive progress must be made in test prescription to reduce the excessive rate of positive D-dimer tests (78%) and positive measurements that are not followed up by radiology (42%).
Freyburger
G
G
Laboratoire d'Hématologie, Hôpital Pellegrin, Université de Bordeaux II, France. freyburg@quaternet.fr
Trillaud
H
H
Labrouche
S
S
Gauthier
P
P
Javorschi
S
S
Grenier
N
N
D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D019281:Dimerization; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis*; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013923:Thromboembolism / Q000097:blood / Q000175:diagnosis*; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis*
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D011933:Reagent Kits, Diagnostic