The prevalence was highest for pulmonary embolism (183 patients 32%), followed by cancer (168 patients 29%), sepsis (142 patients 24%), trauma/surgery (142 patients 24%), and deep vein thrombosis (73 patients 13%).Īlthough D-dimer testing has a reputation for being very non-specific, an extremely elevated D-dimer is uniquely associated with severe disease, mainly including VTE, sepsis and/or cancer. Altogether, 89% of these patients had a diagnosis of VTE, sepsis and/or cancer. After exclusion of 120 duplicate cases, 53 patients undergoing cardiopulmonary resuscitation, and 5 cases without diagnostic information, 581 cases were analysed. Electronic medical records were reviewed for diagnoses.Ī total of 759 extremely elevated D-dimer results were identified. The result of this is, older patients often have more. 80 years of age) the specificity is quoted as 0 18. Specificity can range from 49 67 in patients 50 years of age, but in older patients (i.e. more false positive tests) in older patients. Retrospective cohort study of patients > 18 years with an extremely elevated (> 5000 μg/l > 10x cut-off to exclude VTE) D-dimer test result. D-dimer has been shown to increase with age, which can cause a lower specificity (i.e. Several D-dimer assays have been validated in dogs, including the semiquantitative Accuclot D-dimer latex agglutination assay (Sigma Chemical), the immunometric POC NycoCard assay (Axis shield PoC), the Tina-Quant (a) immunoturbidometric D-dimer assay (Boehringer), and the canine-specific immunochromatographic AGEN canine D-dimer test (Sigma Chemical). Our aim was to assess the differential diagnosis of extremely elevated D-dimer levels in a hospital setting. An elevation of D-dimer (>500 ng/mL) indicates activation of coagulation with formation and degradation of cross-linked fibrin. For D-dimer, the information conveyed by extremely elevated results may be particularly relevant. A consequence of any test dichotomisation is loss of information that is hidden in the continuous spectrum of results. In these algorithms, low D- dimer cut-off values are used to generate a dichotomous test result that is sensitive, but very non-specific for VTE. D-dimer is routinely measured as part of the clinical diagnosis algorithms for venous thromboembolism (VTE).

D dimer quant