Paucis Verbis: D-Dimer test

Paucis Verbis: D-Dimer test


LabD-Dimer: To order or not to order?

That’s the question when it comes to risk stratifying a patient for a pulmonary embolism with a low pretest probability. One should consider confounding conditions which may cause an elevated D-Dimer level. There’s always confusion about what may cause an elevated D-Dimer besides venous thromboemboli. So I thought I would make a pocket card as a reminder.

PV Card: D-Dimer Test

Adapted from 1
Go to the ALiEM Cards site for more resources.

Wakai A, Gleeson A, Winter D. Role of fibrin D-dimer testing in emergency medicine. Emerg Med J. 2003;20(4):319-325. [PubMed]

Michelle Lin, MD
ALiEM Editor-in-Chief
Academy Endowed Chair of EM Education
Professor of Clinical Emergency Medicine
University of California, San Francisco
Michelle Lin, MD
Michelle Lin, MD

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  • Anonymous

    What about aortic dissection?

    • Interesting question. In my mind, it’s not ready for primetime. I’m not totally convinced of its utility although preliminary studies seem encouraging. Most are retrospective studies as well. Also some studies don’t focus on our patient population in the ED (many are normal healthy patients). See the Annals of EM’s EBM useful discussion:

      If you can’t download the article, email me and I’ll forward to you.