Document Detail


Radiologic diagnoses of patients who received imaging for venous thromboembolism despite negative D-dimer tests.
MedLine Citation:
PMID:  18022499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The literature supports a negative D-dimer (-DD) excluding venous thromboembolic disease (VTE) in low-risk patients. We determined the radiologic diagnoses in patients where imaging was ordered despite a -DD. METHODS: This is a retrospective chart review of patients with a -DD (Tinaquant; Roche Diagnostics, Mannheim, Germany) and a radiologic study within 48 hours, sought to determine radiologic diagnosis (primary outcome), treatment of VTE, and consensus diagnosis of acute VTE. RESULTS: Among 3462 DD tests, 1678 met the inclusion criteria. Of 1362 patients with DD values of 350 ng/mL or less, 166 (12.2%) had radiologic studies: 93.4% of the final radiologic diagnoses were negative for VTE, 3.6% were indeterminate, and 3.0% (1.0%-6.9%) were positive; 1.8% ultimately had a consensus diagnosis of acute VTE. In 316 patients with DD values between 351 and 500 ng/mL, 88 (27.8%) had radiologic studies: 95.5% were negative, 1.1% were indeterminate, and 3.4% (0.7%-9.6%) were positive. CONCLUSIONS: Of patients who receive radiologic studies despite -DD tests, 3.0% have positive radiologic diagnoses for acute VTE; only 1.8% had acute VTE after the review of their hospital course.
Authors:
Kristen E Nordenholz; Michael Zieske; Debra S Dyer; James A Hanson; Kennon Heard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  25     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-20     Completed Date:  2007-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1040-6     Citation Subset:  IM    
Affiliation:
Division of Emergency Medicine, Department of Surgery, University of Colorado School of Medicine, Colorado Emergency Medicine Research Center, Denver, Colorado 80262, USA. kristen.nordenholz@uchsc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Diagnostic Imaging*
Female
Fibrin Fibrinogen Degradation Products / analysis*
Humans
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Thromboembolism / blood*,  diagnosis*
Venous Thrombosis / blood*,  diagnosis*
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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