title: Evaluation of the innovance d-dimer assay for the diagnosis of disseminated intravascular coagulopathy in different clinical settings.
abstract: Disseminated intravascular coagulopathy (DIC) is a serious disease with fatal consequences. We prospectively analyzed Innovance d-dimer immunoturbidimetric assay in 68 patients diagnosed with DIC on the background of malignancy (22), severe infection (20), or multitrauma (26) at a single institution between January 2010 and January 2011. Median age was 61 years (range 20-89). All patients were assessed according to the International Society of Thrombosis and Haemostasis (ISTH) DIC score. Applying a threshold of Innovance d-dimer of 10 mg/L fibrinogen equivalent unit (normal <0.5) was correlated with the highest sensitivity in malignancy (86%) and trauma/surgery (80%) compared to 54% in infection. The specificity remained high at 97% in infection, 81% in trauma and 77% in malignancy with a negative predictive value of 97% in trauma and malignancy, and 88% in infection. Our data suggest that Innovance d-dimer is a useful and simple tool that enhances the ISTH DIC diagnostic criteria. Further studies to confirm these findings are warranted.
authors.affiliation: 1Department of Pathology and Haematology, Launceston General Hospital, Launceston, Tasmania, Australia.
authors.forename: Alhossain
authors.initials: A
authors.lastname: Khalafallah
authors.forename: Chris
authors.initials: C
authors.lastname: Jarvis
authors.forename: Michael
authors.initials: M
authors.lastname: Morse
authors.forename: Abdul-Majeed
authors.initials: AM
authors.lastname: Albarzan
authors.forename: Phoebe
authors.initials: P
authors.lastname: Stewart
authors.forename: Gerald
authors.initials: G
authors.lastname: Bates
authors.forename: Robert
authors.initials: R
authors.lastname: Hayes
authors.forename: Iain
authors.initials: I
authors.lastname: Robertson
authors.forename: David
authors.initials: D
authors.lastname: Seaton
authors.forename: Terry
authors.initials: T
authors.lastname: Brain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007239:Infections / Q000097:blood; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000097:blood; D055815:Young Adult
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D