Use of SimpliRED D-dimer assay and computerised tomography in the diagnosis of acute pulmonary embolism

Use of SimpliRED D-dimer assay and computerised tomography in the diagnosis of acute pulmonary embolism

Abstract

Background: The utility of D-dimer in the diagnostic workup of pulmonary embolism has been established. Several D-dimer tests are available with different sensitivities and specificities. SimpliRED D-dimer is a rapid qualitative whole blood D-dimer assay suitable for bedside use.

Objective: To assess the utility of the SimpliRED D-dimer test in patients with suspected acute pulmonary embolism in the absence of formal ‘risk scoring’.

Design: A prospective study measuring SimpliRED D-dimer in unselected patients undergoing computed tomographic pulmonary angiography (CTPA) examination for suspected acute pulmonary embolism.

Main outcome measures: D-dimer and CTPA results were compared. Sensitivity, specificity, and positive and negative predictive values of SimpliRED D-dimer were calculated for the unselected patient group.

Results: Forty-seven patients underwent D-dimer testing and CTPA. SimpliRED D-dimer was positive in 23 and negative in 24 patients. D-dimer was positive in only 6 (50%) of the 12 patients with positive CTPA. Of the 35 with negative CTPA, 17 had positive D-dimer. The positive predictive value of the D-dimer was 26.1 % and the negative predictive value 75.0%.

Conclusion: SimpliRED D-dimer should not be used in the diagnosis of pulmonary embolism in the absence of risk scoring.
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References

  1. Gjores JE. The incidence of venous thrombosis and its sequelae in certain districts of Sweden. Acta Chir Scand 1965; Suppl. 206: 1–88.
  2. Anderson Jr FA, Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep venous thrombosis and pulmonary embolism. Arch Int Med 1991; 151: 933–938.
  3. Robin ED. Overdiagnosis and overtreatment of pulmonary embolism: the emperor may have no clothes. Ann Int Med 1977; 87: 775–781.
  4. Hull RD, Hirsh J, Carter CJ, et al. Diagnostic value of ventilation-perfusion lung scanning in patients with suspected of pulmonary embolism. Chest 1985; 88: 819–828.
  5. PIOPED investigators. Value of ventilation-perfusion scan in acute pulmonary embolism: results of the prospective investigation of pulmonary embolism diagnosis. JAMA 1990; 263: 2753–2759.
  6. British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines of the management of suspected acute pulmonary embolism. Thorax 2003; 58: 470-484.
  7. Stein PD, Hull RD, Saltzman HA, Pineo G. Strategy for diagnosis of patients with suspected acute pulmonary embolism. Chest 1993; 103: 1553–9.
  8. Hull RD, Hirsh J, Carter CJ, et al. Pulmonary angiography, ventilation lung scanning and venography for clinically suspected embolism with abnormal perfusion lung scan. Ann Intern Med 1983; 98: 891–9
  9. Bounameaux H, de Moerloose P, Perrier A, Miron M-J. D-dimer testing in suspected venous thromboembolism: an update. Q J Med 1997; 90: 437–42.
  10. Kelly J, Rudd A, Lewis R, Hunt B. Plasma D-dimers in the diagnosis of venous thromboembolism. Arch Intern Med 2002; 1162: 747–56.
  11. Stein PD, Hull RD, Patel KC, et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism. A systematic review. Ann Intern Med 2004; 140: 589–60.
  12. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med 2001; 135(2): 98–107.
  13. Ginsberg JS, Wells PS, Kearon C, et al. Sensitivity and Specificity of a Rapid Whole-Blood Assay for D-dimer in the Diagnosis of Pulmonary Embolism. Ann of Intern Med 1998; 129(12): 1006–11.
  14. MacGillavry MR, Lijmer JG, Sanson BJ, et al. Diagnostic accuracy of triage tests to exclude pulmonary embolism. Thromb Haemost 2001; 85: 995–8.
  15. Kruip MJ, Leclercq MG, van der heul C, et al. Diagnostic strategies for excluding pulmonary embolism in clinical outcome studies: a systemic review. Ann Intern Med 2003; 138: 941–951.
  16. Bates SM, Grand Maison A, Johnston M, et al. A latex D-dimer reliably excludes venous thromboembolism. Arch Intern Med 2001; 161: 447–53.

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Use of SimpliRED D-dimer assay and computerised tomography in the diagnosis of acute pulmonary embolism

3rd March 2016
PMID: 21603677
Authors Affiliations
Deepak Subedi Department of Radiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA
Derek Bell Department of Acute Medicine Director NIHR CLAHRC for Northwest London Chelsea and Westminster Hospital Imperial College London Fulham Road London SW10 9NH Email: d.bell@imperial.ac .uk © 2010
Shazad Aslam Department of Thoracic Surgery, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA
Marina J Brochwitz Lewinski Department of Radiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA
John T Murchison Department of Radiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA

Use of SimpliRED D-dimer assay and computerised tomography in the diagnosis of acute pulmonary embolism

Cite this article as:

Subedi D, Bell D, Brochwitz-Lewinski MJ, Aslam S, Murchison JT. Use of SimpliRED D-dimer assay and computerised tomography in the diagnosis of acute pulmonary embolism. Acute Med. 2009;8(2):85-7. PMID: 21603677.

Use of SimpliRED D-dimer assay and computerised tomography in the diagnosis of acute pulmonary embolism

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