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Clinical Investigations: PULMONARY EMBOLISM |

Clinical Utility of D-dimer in Patients With Suspected Pulmonary Embolism and Nondiagnostic Lung Scans or Negative CT Findings*

Suman W. Rathbun; Thomas L. Whitsett; Sara K. Vesely; Gary E. Raskob
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*From the Department of Medicine (Drs. Rathbun and Whitsett), College of Medicine; and the Department of Biostatistics and Epidemiology (Drs. Vesely and Raskob), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK.

Correspondence to: Suman W. Rathbun, MD, Department of Medicine, WP 3120, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd, Oklahoma City, OK 73104; e-mail: suman-rathbun@ouhsc.edu



Chest. 2004;125(3):851-855. doi:10.1378/chest.125.3.851
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Background: The diagnosis of pulmonary embolism is difficult because the clinical diagnosis is nonspecific and all of the objective tests have limitations. The assay for plasma d-dimer may be useful as an exclusion test if results are negative. We conducted a prospective cohort study that evaluated the clinical utility (usefulness) of an automated quantitative d-dimer test in the diagnosis of patients with suspected pulmonary embolism.

Methods: Consecutive eligible patients who had clinically suspected PE with nondiagnostic lung scans or negative helical CT scan of the chest results underwent d-dimer testing.

Results: The d-dimer results were negative in 11 of 103 inpatients (10.6%, 95% confidence interval [CI], 5.5 to 18.3%) and 7 of 22 outpatients (31.8%, 95% CI, 13.9 to 54.9%; p = 0.02).

Conclusions: Measurement of plasma d-dimer is of limited clinical utility for inpatients with clinically suspected pulmonary embolism and nondiagnostic lung scans or negative helical CT results at a US academic health center.

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