Clinical Information

Test is used to evaluate Pulmonary Embolism (PE), Deep Vein Thrombosis (DVT), and DIC.

It should be noted that the published studies evaluating this assay have included only Emergency Room or other outpatient presenting with new symptoms suggestive of thromboembolic disease. This assay has not been evaluated for this purpose in hospital inpatients, postoperative patients, or other patient types than those indicated.

Elevated D-Dimers may be seen in activation states of coagulation.  Elevated states of D-Dimer levels may be associated with the following:  DVT, DIC, hemorrhages, fibrinolysis, post-operative periods, cancer, and severe infections.  D-Dimer levels may be falsely elevated in underlying, non-thrombotic conditions common in hospitalized patients.  Cut-off value for D-dimer use in evaluation of VTE is 500 ng/mL FEU.

The measurement of D-Dimer should not be used as an aid in the diagnosis of VTE in patients with:

• Therapeutic dose anticoagulant therapy for >24 hours
• Fibrinolytic therapy within previous 7 days
• Trauma or surgery within previous 4 weeks
• Aortic aneurysm
• Sepsis, severe infections, pneumonia, severe skin infections
• Liver cirrhosis
• Renal Failure
• Pregnancy

The American College of Emergency Physicians, the American College of Physicians and the American Society of Hematology recommend that in patients older than 50 years with low-to-intermediate pretest probability for acute pulmonary embolism, an age-adjusted D-dimer cutoff of age x 10 (FEU units) can be used to exclude a diagnosis of PE without need for further imaging.

Ann Emerg Med. 2018;71:e59-e109 Ann Intern
Med.2015;163:701-711 Blood Adv 2018;2:3226