Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Detection of acute thoracic aortic dissection with D-dimer.
A short cut review was carried out to establish whether a raised D-dimer could be used to identify patients with an acute thoracic aortic dissection. Seven papers were found addressing the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are presented in table 1. The clinical bottom line is that a D-dimer value <500 ng/ml makes the diagnosis unlikely but there is still the possibility of a thrombosed false lumen.
VanderLinden
Chad
C
Grand Rapids MERC/Michigan State University, Michigan, USA.
D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D