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Emergency Medicine International
Volume 2012, Article ID 517375, 6 pages
http://dx.doi.org/10.1155/2012/517375
Clinical Study

Shifting Up Cutoff Value of D-Dimer in the Evaluation of Pulmonary Embolism: A Viable Option? Possible Risks and Benefits

Department of Emergency Medicine, Rambam Health Care Campus, Haifa 31096, Israel

Received 5 April 2012; Revised 21 May 2012; Accepted 4 June 2012

Academic Editor: Chak W. Kam

Copyright © 2012 Bennidor Raviv and Shlomo H. Israelit. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To evaluate the viability of the possibility to use a higher D-dimer value than the one used today in the clinical algorithms evaluating patients suspected to have pulmonary embolism. Methods. A retrospective analysis of 300 serial patients for whom D-dimer values were taken during a 10 month period in the emergency room of a tertiary medical center. Results. Our analysis showed that it may be safe and cost effective to use a D-dimer value of 900 ng/ml rather than the value of 500 ng/ml accepted today, with sensitivity of 94.4%. In younger patients [under 40 years] the sensitivity reached was even higher—100%. Conclusions. Raising cutoff values of D-dimer in screening for pulmonary embolism seems a viable option. There may be a place for “tailoring” cutoff values according individual patient characteristics, such as according age groups. More studies of the subject are warranted.