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D-Dimer Testing in the Diagnosis of Cerebral Vein Thrombosis: a Systematic Review and a Meta-Analysis of the Literature.
MedLine Citation:
PMID:  22257124     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Quantitative measurement of circulating D-dimer, a product of fibrin degradation, has been shown to be a very useful diagnostic tool in the management of patients with suspected deep vein thrombosis and/or pulmonary embolism. Whether D-dimer can play a similar role also in the diagnostic approach in patients with suspected cerebral vein thrombosis (CVT) remains controversial. Methods: Studies evaluating the diagnostic accuracy of the D-dimer test in the diagnosis of CVT were systematically searched for in the MEDLINE and EMBASE databases (up to July 2011). Weighted mean sensitivity and specificity with 95% confidence intervals (CIs) were calculated using a bivariate random-effects regression approach. Results: Fourteen studies for a total of 1134 patients were included. D-dimer accuracy was good with a resulting weighted means sensitivity of 93.9% (95% CI 87.5, 97.1%) and weighted mean specificity of 89.7% (95% CI 86.5, 92.2%) calculated using a bivariate approach. Potential risk factor for false negative D-dimer included isolated headache, longer duration of symptoms and limited sinus involvement. Conclusions: our findings suggest that D-dimer may be a useful diagnostic tool in the management of patients with suspected CVT. Future prospective studies are warranted to confirm our preliminary findings.
Authors:
F Dentali; A Squizzato; C Marchesi; M Bonzini; J M Ferro; W Ageno
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-18
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 International Society on Thrombosis and Haemostasis.
Affiliation:
Department of Clinical Medicine, Insubria University, Varese Epidemiology and Preventive Medicine Research Centre, Department of Experimental Medicine, University of Insubria, Varese, Italy Department of Neurosciences, Hospital Santa Maria, University of Lisbon, Lisbon, Portugal.
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