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Plasma D-dimer for Outcome Assessment in Patients With CAP: Not a Replacement for PSI

R. Andrew McIvor, MD, MSc, FCCP
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Affiliations: Halifax, NS, Canada
 ,  Dr. McIvor is Associate Professor of Medicine, Head Division of Respirology, Dalhousie University.

Correspondence to: R. Andrew McIvor, MD, MSc, FCCP, Associate Professor of Medicine, Head, Division of Respirology, Dalhousie University, Halifax, NS, Canada B3H 4R2.



Chest. 2004;126(4):1015-1016. doi:10.1378/chest.126.4.1015
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Community-acquired pneumonia (CAP) is diagnosed in approximately 4 million adults annually in the United States with > 600,000 of these requiring hospitalization.1 Many investigators have strived to identify a simple blood test or to develop prediction rules that can help physicians make more rational decisions in identifying patients who are at low risk for adverse outcomes or death.

Physicians continue to be conservative and to overestimate the risk of death in patients with pneumonia, and these overestimates are associated with a decision to hospitalize many patients unnecessarily. Health care has changed significantly, with physicians no longer admitting patients to the hospital to make them better, but primarily to provide services and medications that are not easily provided in the home circumstance and/or to monitor them for complications of the presenting illness or for therapy thereof.

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