D-DIMER RELEVANCE IN THROMBOEMBOLIC SYNDROMES
Abstract:
D-dimer marker analysis is relatively inexpensive, simple to perform, done at the bedside
together with other manoeuvres and not requiring any special preparation. We aimed at demonstrating
diagnostic effectiveness of D-dimers as a method of first choice in the diagnosis of thrombotic events. We
conducted a retrospective descriptive epidemiological study over a period of 3 years. Patients were
selected from all the cases that were presented in the Emergency Unit within the Clinical County
Emergency Hospital of Sibiu in whom D-dimer markers were harvested. Of the initial batch of 310 people
who had D-dimer testing, we selected a group of 193 patients who had positive D-dimer results. Of the
193 patients with positive D-dimer results, 22 were confirmed with TEP (12%) and 12 with TVP (7%) and
a total of 7 patients presented both disorders simultaneously. A percentage of 81% of the total patients
with positive D-dimer results were diagnosed with conditions in which the value of D-dimers could
increase non-specifically. 15% of all cases of TVP resulted in death. For TEP, there were 37% patients
who died; in 55% of the cases the values of D-dimers were> 1600ng/l and 37.5% had values> 3200ng/l.
TEP diagnosis was confirmed in D-dimers negative values (below 200 ng/l) in 2 cases in the study group.
Conclusions: The high negative predictive value of D-dimers (between 0, 98-1.00) reveals that a value of
D-dimers below 200 ng/l excludes in over 98% of cases the thrombotic syndrome. Very high negative
predictive value of D-dimers indicates an important role, especially in the diagnosis of exclusion of the
thrombotic syndromes (TEP and TVP) than in the positive diagnosis.
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