title: D-dimers in the emergency department evaluation of aortic dissection.
abstract: Aortic dissection (AD) is the most common acute aortic condition requiring urgent surgery. AD, if not diagnosed in the emergency department (ED), is frequently fatal. AD is a difficult antemortem diagnosis.
  
  
  OBJECTIVE
  To determine if acute AD is associated with an elevation of fibrin degradation products, D-dimers.
  
  
  METHODS
  This was a retrospective chart review of patients diagnosed as having AD in the ED in whom a D-dimer determination was obtained in the ED, prior to any therapeutic intervention. The study was conducted in an urban Level I trauma center between October 1996 and September 2000. Exclusion criteria were referred patients with known diagnosis of AD. The D-dimer assay used was the semiquantitative latex agglutination assay, with a normal range up to 0.5 micro g/mL.
  
  
  RESULTS
  One hundred fifty-six patients were diagnosed as having AD in the ED. Seven patients had a D-dimer assay during their workup. All seven had a positive test.
  
  
  CONCLUSIONS
  All seven patients with an AD who had D-dimer assays performed in the ED had positive results by latex agglutination.
authors.affiliation: Department of Emergency Medicine, University of Connecticut School of Medicine, Hartford Hospital, 80 Seymour Street, PO Box 5037, Hartford, CT 06102-5037, USA. aaperez@harthosp.org
authors.forename: Alberto
authors.initials: A
authors.lastname: Perez
authors.forename: Philippe
authors.initials: P
authors.lastname: Abbet
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Drescher
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000097:blood* / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007841:Latex Fixation Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D