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Normal D-dimer concentration is a common finding in symptomatic outpatients with distal deep vein thrombosis
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of clinical chemistry. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
2005 (English)In: Blood Coagulation and Fibrinolysis, ISSN 0957-5235, Vol. 16, no 7, 517-523 p.Article in journal (Refereed) Published
Abstract [en]

The D-dimer analysis has been shown to have a high sensitivity and a high negative predictive value for the exclusion of deep vein thrombosis (DVT). However, most D-dimer studies, including recent clinical management studies, are performed without examination of the calf veins and/or performed on patient populations with a predominance of proximal DVT. The purpose of this study was to evaluate the diagnostic performance of the D-dimer test in a population with a suspected high incidence of distal DVT. In the present study, 393 outpatients with clinically suspected symptomatic DVT of the lower extremities were examined with whole-leg duplex ultrasonography. The D-dimer analysis was performed using an automated micro-latex assay (Tina-quant). A total of 137 of 393 patients had a proven DVT, with the majority presenting with distal DVT (59%). Twenty-eight out of 81 patients with distal DVT had a normal D-dimer, compared with two of 56 patients with proximal DVT. The sensitivity for distal DVT was only 65% compared with 96% for proximal DVT, the negative predictive values were 84 and 99%, respectively. In conclusion, the prevalence of distal DVT in a study population seems to have a great impact on the diagnostic performance of the D-dimer analysis. The study results also show that normal D-dimer levels do not exclude distal DVT in outpatients, instead, it can be hypothesized that normal D-dimer levels exclude DVT that require treatment, as indicated by the good outcome in recent management studies. © 2005 Lippincott Williams & Wilkins.

Place, publisher, year, edition, pages
2005. Vol. 16, no 7, 517-523 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-31047Local ID: 16764OAI: diva2:251870
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2011-01-12

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Jennersjö, CeciliaLindahl, Tomas
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Faculty of Health SciencesInternal MedicineDepartment of Acute Internal MedicineDivision of clinical chemistryDepartment of Clinical Chemistry
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