Evaluation of a test for rapid detection of D-dimers for the exclusion of the diagnosis of venous thrombosis
Jacq, F.; Héron, E.; Rance, A.; Césarini, M.L.; Emmerich, J.; Fiessinger, J.N.
Presse Medicale 26(24): 1132-1134
1997
ISSN/ISBN: 0755-4982 PMID: 9255239 Document Number: 476315
The SimpliRED whole blood D-dimer assay for exclusion of deep venous thrombosis in symptomatic outpatient appears to be a simple and rapid method; we wanted to confirm its reliability. Fifty consecutive outpatients (mean age 57, range 20 to 89) referred to our department between September and December 1996, for clinically suspected deep venous thrombosis (DVT) were included. Hospitalized patients were excluded as well as patients under anticoagulant and pregnant women. DVT was diagnosed with our usual strategy of compression ultrasonography at the levels of the common femoral, the superficial femoral and the popliteal veins including the exploration of sural and saphenous veins. The D-dimer assay was performed, according to the manufacturer recommendation, blindly by a physician unaware of the results of ultrasonography within one hour. Eight of nineteen patients with DVT had a normal D-dimer test result Four had a sural DVT, but four had a proximal DVT. Furthermore four patients with normal D-dimers had superficial venous thrombosis. Our series does not confirm the high sensitivity and negative predictive value reported previously. To date it is premature to propose this assay as a first line test in the therapeutic management of patients with suspected DVT.