Podcast #90: D-Dimer

21cf2be8-cd2f-44fe-979d-94feefab3c02Run Time: 4 minutes

Author: Dr. Jared Scott

Educational Pearls:

  • The D-Dimer test is not applicable to high-risk patient populations – due to false negatives – a patient with multiple risk factors should go straight to CT.
  • The age-adjusted d-dimer – older people get false positives – above the age of 50 add .1 to the d-dimer for every extra decade of life.
  • Study showed that of patients with a d-dimer < 0.50 none got CT scans and there was 1 missed PE. Between 0.50 and a normal age-adjusted d-dimer there was 1 missed confirmed non-fatal PE and 7 missed suspected DVTs. Lastly, of all the patients that got CT scans there was a 0.5% miss rate.
  • The study concluded that this was an acceptable sensitivity for the d-dimer – sensitivity is 97% with the age-adjusted d-dimer, a CT scan has 98% sensitivity.
  • The age-adjusted d-dimer can help avoid the cost of a CT scan and kidney damage.

Link to Podcast:  http://medicalminute.madewithopinion.com/d-dimer/

References:  http://jama.jamanetwork.com/article.aspx?articleid=1841967&resultClick=3

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