JRSM > Volume 98, Number 2 > Pp. 54-58

This Article Figures Only Full Text Full Text (PDF) Send a Quick Comment Alert me when this article is cited Alert me when Quick Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hammond, C. J Articles by Hassan, T. B Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?

Screening for pulmonary embolism with a D-dimer assay: do we still need to assess clinical probability as well?

Christopher J Hammond BM MRCS     Tajek B Hassan MD FFAEM  

Department of Accident and Emergency, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK

Correspondence to: C J HammondE-mail: doctorhammond{at}ntlworld.com

Clinical risk stratification and D-dimer assay can be of use in excluding pulmonary embolism in patients presenting to emergency departments but many D-dimer assays exist and their accuracy varies. We used clinical risk stratification combined with a quantitative latex-agglutination D-dimer assay to screen patients before arranging further imaging if required. Retrospective analysis of a sequential series of 376 patients revealed that no patient with a D-dimer of <275 ng/mL was diagnosed with pulmonary embolism, irrespective of clinical probability. We conclude that a latex-agglutination assay could be used to exclude pulmonary embolism without the necessity for clinical risk stratification. If these findings are borne out by further work, D-dimer strategies to exclude pulmonary embolism could substantially reduce imaging workload.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?